Hemorrhagic complications of optic disc drusen and available treatment options

Romero, Johnlee; Sowka, Joseph; Shechtman, Diana

doi:10.1016/j.optm.2008.01.020

Cited by 19 publications

(18 citation statements)

References 16 publications

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“…They occur in 0.4–20.4% of the population and may be bilateral (67–91%) and familial (autosomal dominant) [ 6 , 7 , 10 – 12 , 15 , 17 , 19 – 21 ]. They show a predominance for females (58–71%) and Caucasians [ 3 , 7 , 12 , 20 ]. ODD are often benign and asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…Optic disc drusen (ODD) may be associated with subretinal hemorrhage as a result of direct mechanical compression and rupture of subretinal vessels at the optic disc, resulting in peripapillary subretinal hemorrhage [ 1 – 5 ]. Mechanical impairment of peripapillary circulation also results in retinal ischemia and release of vascular endothelial growth factor (VEGF), which may trigger the development of choroidal neovascularization (CNV) and/or polypoidal choroidal vasculopathy (PCV), leading to subretinal haemorrhage [ 3 , 6 – 10 ]. Compromise in central venous outflow with increased retinal central venous pressures from direct mechanical effects of enlarging ODD results in central retinal vein occlusion (CRVO) [ 1 , 2 , 7 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Case Report of Optic Disc Drusen with Simultaneous Peripapillary Subretinal Hemorrhage and Central Retinal Vein Occlusion

Law

Yang

Teoh

2014

Case Reports in Ophthalmological Medicine

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A 52-year-old Chinese gentleman presented with right eye floaters and photopsia over one week. His visual acuities were 20/20 bilaterally. Posterior segment examination showed a right eye swollen optic disc and central retinal vein occlusion (CRVO) associated with an area of subretinal hemorrhage adjacent to the optic disc. Fundus fluorescein (FA) and indocyanine green angiographies (ICGA) of the right eye did not demonstrate choroidal neovascularization (CNV), polypoidal choroidal vasculopathy (PCV), or retinal ischemia. Ultrasound B-scan revealed optic disc drusen (ODD). In view of good vision and absence of CNV, he was managed conservatively with spontaneous resolution after two months. Commonly, ODD may directly compress and mechanically rupture subretinal vessels at the optic disc, resulting in peripapillary subretinal hemorrhage, as was likely the case in our patient. Mechanical impairment of peripapillary circulation also results in retinal ischemia and may trigger the development of choroidal neovascularization (CNV) and/or polypoidal choroidal vasculopathy (PCV), leading to subretinal haemorrhage. Compromise in central venous outflow with increased retinal central venous pressure from the direct mechanical effects of enlarging ODD results in central retinal vein occlusion (CRVO). Patients with subretinal hemorrhage and CRVO from ODD should be monitored closely for the development of potentially sight-threatening complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case Report of Optic Disc Drusen with Simultaneous Peripapillary Subretinal Hemorrhage and Central Retinal Vein Occlusion

Law

Yang

Teoh

2014

Case Reports in Ophthalmological Medicine

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“…The prevalence of retinal hemorrhages in patients with ODD is from 2% to 10% [15][16][17][18]. Sanders et al distinguish four types of bleeding in the retina in relation to ODD: 1) small, transient, asymptomatic splinter hemorrhages on the head of the optical disc; 2) bleeding from the head of the optic nerve extending into the vitreous body and causing transient symptomatic defects in the visual field; 3) deep papillary hemorrhage, and 4) deep peripapillary hemorrhage that can infect the region of the macula, accompanied by severe visual impairment and permanent defects in the visual field [16,19].…”

Section: Discussionmentioning

confidence: 99%

Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

et al. 2014

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Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

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“…Optic head drusen has also been associated with peripapillary retinal neovascularization and haemorrhagic complications in some cases. 69,70 Ultrasound is a good diagnostic method to evaluate patients who have blurred optic discs and in whom drusen are suspected. 71 …”

Section: Pseudopapilledema (Optic Disc Drusen)mentioning

confidence: 99%

Congenital Anomalies of the Optic Nerve

2010

The Retinal Atlas

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Hemorrhagic complications of optic disc drusen and available treatment options

Cited by 19 publications

References 16 publications

Case Report of Optic Disc Drusen with Simultaneous Peripapillary Subretinal Hemorrhage and Central Retinal Vein Occlusion

Case Report of Optic Disc Drusen with Simultaneous Peripapillary Subretinal Hemorrhage and Central Retinal Vein Occlusion

Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

Congenital Anomalies of the Optic Nerve

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