Differentiation of Optic Nerve Head Drusen and Optic Disc Edema with Spectral-Domain Optical Coherence Tomography

Lee, Kyoung Min; Woo, Se Joon; Hwang, Jeong‐Min

doi:10.1016/j.ophtha.2010.09.006

Cited by 135 publications

(122 citation statements)

References 13 publications

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“…[8][9][10] Nevertheless, OCT is limited by its inability to examine the retrobulbar anatomy or identify optic nerve sheath abnormalities, which are important advantages to orbital ultrasonography. 27 A recent study failed to find any significant difference in retinal nerve fiber layer thickness between patients with buried optic nerve head drusen and those with mild papilledema secondary to IIH using spectral domain OCT. 28 The reported diagnostic accuracy among trained readers of these images was also poor, suggesting that ultrasonography may be both quantitatively and qualitatively more suitable for this application.…”

Section: Discussionmentioning

confidence: 99%

“…These tests include magnetic resonance imaging (MRI) of the brain and orbits to look for structural intracranial lesions or signs of intracranial hypertension; 3 orbital ultrasonography to look for buried drusen or presence or absence of dilated retrobulbar optic nerve sheaths; 4 and lumbar puncture to measure intracranial pressure. 5 In addition, computed tomography (CT) scan of the orbits, 6 fluorescein angiography, 7 and optical coherence tomography (OCT) [8][9][10] have also been utilized in differentiating these two conditions. Among these modalities, orbital ultrasonography is a useful tool that is rapid, minimally invasive, cost-effective, and poses minimal risk to patient safety.…”

Section: Introductionmentioning

confidence: 99%

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The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Carter

Pistilli

Livingston

et al. 2014

Eye

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Purpose To determine the sensitivity and specificity of orbital ultrasonography in distinguishing papilledema from pseudopapilledema in adult patients. Methods The records of all adult patients referred to the neuro-ophthalmology service who underwent orbital ultrasonography for the evaluation of suspected papilledema were reviewed. The details of history, ophthalmologic examination, and results of ancillary testing including orbital ultrasonography, MRI, and lumbar puncture were recorded. Results of orbital ultrasonography were correlated with the final diagnosis of papilledema or pseudopapilledema on the basis of the clinical impression of the neuro-ophthalmologist. Ultrasound was considered positive when the optic nerve sheath diameter was Z3.3 mm along with a positive 301 test. Results The sensitivity of orbital ultrasonography for detection of papilledema was 90% (CI: 80.2-99.3%) and the specificity in detecting pseudopapilledema was 79% (CI: 67.7-90.7%). Conclusions Orbital ultrasonography is a rapid and noninvasive test that is highly sensitive, but less specific in differentiating papilledema from pseudopapilledema in adult patients, and can be useful in guiding further management of patients in whom the diagnosis is initially uncertain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Carter

Pistilli

Livingston

et al. 2014

Eye

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“…The differential diagnosis of ODD with other conditions, especially pseudopapillary oedema with hidden drusen and optic disc oedema has been a research topic in recent years [18,19]. …”

Section: Discussionmentioning

confidence: 99%

Ophthalmic Features of Optic Disc Drusen

2012

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Purpose: To evaluate the ophthalmoscopic manifestations of patients with visible and hidden optic disc drusen (ODD). Method: We studied 55 patients (100 eyes) with ODD that were confirmed using B-scan ultrasonography and a control group of 60 patients (100 eyes) for differential diagnosis. We analysed the optic nerve features with stereoscopic photography and compared the characteristics between visible and hidden ODD and between hidden ODD and papilloedema. Results: The patients with ODD presented the following ophthalmoscopic features: visible drusen (52%), blurred edges (84%), raised optic disc (74%), absence of optic disc cupping (69%), absence of venous pulse (54%), abnormal vascular branching (81%), presence of cilioretinal vessels (42%), peripapillary atrophy (56%) and haemorrhages (2%). Comparison of the qualitative characteristics of the papillae of the eyes with visible and hidden ODD showed statistically significant differences in all parameters studied, except for morphological alterations (p = 0.851) and haemorrhage (p = 0.954). Comparison of hidden ODD with papilloedema showed statistically significant differences in blurred edges, disc elevation, absence of optic disc cupping, altered colour, anomalous vascular branching and optic disc haemorrhages (p < 0.005). Conclusions: Ophthalmologic features associated with ODD can help us to diagnose their presence and avoid confusing them with papilloedema.

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“…Optic nerve head drusen (ONHD) are acellular hyaline deposits of calcium, amino and nucleic acids, and mucopolysaccharides, found in the prelaminar portion of the optic nerve head believed to arise from altered retinal ganglion cell (RGC) axoplasmic flow 1,2 .…”

Section: Introductionmentioning

confidence: 99%

“…Superficial ONHD are also more commonly associated with visual field defects than those located more deeply 2 . Despite the lack of quantitative longitudinal imaging studies, it is therefore seems likely that progressive field loss in patients with ONHD is due to progressive drusen enlargement.…”

Section: Introductionmentioning

confidence: 99%

Rapidly Progressing Visual Loss Associated With Optic Nerve Head Drusen: Is There A Role For Lowering Intraocular Pressure?

El-Assal¹,

Tatham²

2016

JOS

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Differentiation of Optic Nerve Head Drusen and Optic Disc Edema with Spectral-Domain Optical Coherence Tomography

Cited by 135 publications

References 13 publications

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

Ophthalmic Features of Optic Disc Drusen

Rapidly Progressing Visual Loss Associated With Optic Nerve Head Drusen: Is There A Role For Lowering Intraocular Pressure?

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