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What Is Nevus of Ota (Oculodermal Melanocytosis)?

Nevus of Ota, also called oculodermal melanocytosis, is a congenital pigmentary condition in which extra melanocytes are present in the dermis and ocular tissues on one side of the face. It produces slate gray or blue brown patches on the periocular skin and temple, along with pigmentation of the sclera, uveal tract, and sometimes the eyelids. The condition is most common in individuals of Asian and African descent and usually appears at birth or in childhood. Although benign in most cases, it carries a small increased risk of glaucoma and uveal melanoma in the affected eye.

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What Is Nevus of Ota (Oculodermal Melanocytosis)?

Nevus of Ota, also called oculodermal melanocytosis, is a congenital pigmentary condition in which extra melanocytes are present in the dermis and ocular tissues on one side of the face. It produces slate gray or blue brown patches on the periocular skin and temple, along with pigmentation of the sclera, uveal tract, and sometimes the eyelids. The condition is most common in individuals of Asian and African descent and usually appears at birth or in childhood. Although benign in most cases, it carries a small increased risk of glaucoma and uveal melanoma in the affected eye.

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Appearance and Distribution

The skin changes in nevus of Ota typically involve the upper and lower eyelids, temple, forehead, and sometimes the cheek on one side, following branches of the ophthalmic and maxillary trigeminal nerves. The color ranges from light slate to dark blue brown and often deepens around puberty. In the eye, the sclera and episclera show patchy blue gray discoloration, and the uveal tract can be more heavily pigmented. The condition is usually unilateral, though bilateral cases exist. Hair in the involved area is typically normal in color.

Ocular Associations and Risks

Ocular melanocytosis can increase pigmentation of the trabecular meshwork and angle structures. This can contribute to higher intraocular pressure and a greater lifetime risk of open angle glaucoma in the involved eye. There is also an elevated risk of uveal melanoma compared with the general population, though the absolute risk is still low. Regular monitoring of intraocular pressure, optic nerve appearance, and fundus pigmentation is recommended. Patients are educated about symptoms such as visual change or new dark spots in the visual field.

Diagnosis and Differential Diagnosis

Diagnosis is clinical, based on the characteristic pattern of dermal and ocular pigmentation on one side of the face. The eye care professional examines the anterior segment, angle, and fundus carefully for pigment distribution. Conditions such as congenital melanocytosis without skin involvement, nevus of Ito, and acquired dermal melanocytosis are considered in the differential. Rarely, similar pigmentation can result from drug deposition or other causes, which are distinguished by history and distribution. Imaging and biopsy are seldom needed but can be used in atypical cases.

Management and Follow-Up

Management focuses on monitoring for ocular complications and addressing cosmetic concerns. Periodic eye examinations track intraocular pressure and optic nerve status, and gonioscopy assesses angle pigmentation. Suspicious choroidal lesions are followed with photography and ultrasound and referred to ocular oncology when needed. Laser or intense pulsed light therapies performed by dermatologists can lighten skin pigmentation in some patients. Long term follow up is advised because glaucoma or melanoma can develop later in life.

FAQs About Nevus of Ota

Is nevus of Ota cancer?

No, it is a benign pigmentary condition, but it is associated with a slightly higher risk of uveal melanoma in the affected eye.

Can nevus of Ota be removed completely?

Skin pigmentation can often be lightened with laser treatments, but results vary and complete removal is not guaranteed.

Will nevus of Ota affect both eyes?

Most cases are unilateral, though the involved eye needs regular monitoring for glaucoma and melanoma.

Can children with nevus of Ota live normal lives?

Yes, with routine eye care and monitoring, most children and adults with nevus of Ota have good vision and normal daily function.

References

American Academy of Ophthalmology (EyeWiki). ?Oculodermal Melanocytosis (Nevus of Ota).? https://eyewiki.org/Oculodermal_Melanocytosis_%28Nevus_of_Ota%29

NCBI Bookshelf (StatPearls). ?Nevus of Ota and Ito.? https://www.ncbi.nlm.nih.gov/books/NBK560574/

DermNet. ?Naevus of Ota, naevus of Ito and naevus of Hori.? https://dermnetnz.org/topics/naevus-of-ota-ito-hori

PubMed. ?Nevus of Ota and Ito.? https://pubmed.ncbi.nlm.nih.gov/32809409/

American Academy of Ophthalmology. ?Nevus of Ota.? https://www.aao.org/image/nevus-of-ota