Coexistence of optic disc drusen and idiopathic intracranial hypertension in a child

Rossiter, J D; Lockwood, Alastair; Evans, Andrew K.

doi:10.1038/sj.eye.6701430

Cited by 23 publications

(11 citation statements)

References 9 publications

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“…115 The presence of optic disc drusen, however, does not exclude true disc edema, and optic disc drusen occur simultaneously with true disc edema in some children. 67; 100; 172 Therefore, in patients with signs or symptoms suspicious for another disorder, further evaluation may be necessary even if optic disc drusen are detected.…”

Section: Discussionmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

113

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Optic disc drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disc drusen, particularly when buried, to simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disc drusen. Complications of optic disc drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, non-arteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for choroidal neovascular membranes. In most cases, however, children with optic disc drusen can be managed by observation with serial examinations and visual field testing, once true optic disc edema has been excluded.

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Section: Discussionmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

113

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“…While the prevalence of optic disc drusen in the general population has been estimated at 2.0% in autopsy studies,16 we uncovered evidence of buried drusen in 48% of study eyes. Optic disc drusen and papilledema have been reported to coexist in patients with paediatric IIH,17 and it is interesting to speculate that optic disc drusen may play a role in the development of papilledema in IIH. Drusen may form as a result of axoplasmic stasis due to small foraminal openings as the optic nerve pierces the sclera’s lamina cribrosa, causing calcifications to accumulate in axonal mitochondria, which are subsequently extruded extracellularly 18.…”

Section: Discussionmentioning

confidence: 99%

Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension

2015

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“…Of note, optic nerve swelling secondary to elevated ICP can coexist in children with optic nerve head drusen. 21 …”

Section: Casementioning

confidence: 99%

Reference Range of Cerebrospinal Fluid Opening Pressure in Children: Historical Overview and Current Data

Avery

2014

Neuropediatrics

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The lumbar puncture and cerebrospinal fluid (CSF) opening pressure (OP) in children remains an essential diagnostic test for children with suspected elevated intracranial pressure. Recent prospective data have revised the normative CSF OP values and described how clinical variables such as age, depth of sedation, and obesity may influence the measurements. In addition, the new normative data are now reflected in revised diagnostic criteria for idiopathic intracranial hypertension/pseudotumor cerebri syndrome. This review highlights the recently published data and provides guidance on how it may impact clinical management.

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Coexistence of optic disc drusen and idiopathic intracranial hypertension in a child

Cited by 23 publications

References 9 publications

Optic disk drusen in children

Optic disk drusen in children

Anatomic and visual function outcomes in paediatric idiopathic intracranial hypertension

Reference Range of Cerebrospinal Fluid Opening Pressure in Children: Historical Overview and Current Data

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