Imaging of Optic Nerve Head Drusen

Yi, Kayoung; Mujat, Mircea; Sun, Wei; Burnes, Daina; Latina, Mark A.; Lin, Derrick T.; Deschler, Daniel G.; Rubin, Peter A. D.; Park, Boris Hyle; Boer, Johannes F. de; Chen, Teresa C.

doi:10.1097/ijg.0b013e31818624a4

Cited by 48 publications

(17 citation statements)

References 25 publications

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“…Various ancillary tests, including B-scan ultrasonography, 55; 105; 151; 168 fundus autofluorescence, 95; 140; 145 orbital computed tomography (CT) scan, 12; 131; 162 fluorescein angiography (FA), 24; 159; 177 scanning laser ophthalmoscopy, 75; 103; 187 electrophysiology, 17; 18; 23; 142; 186 and more recently optical coherence tomography (OCT), 31; 88; 112; 125; 215 have been used to identify optic disc drusen. These tests may be less useful in children who typically have buried drusen that are more difficult to detect.…”

Section: Diagnostic Testingmentioning

confidence: 99%

“…5; 31; 50; 76; 88; 93; 104; 112; 114; 135; 195; 211; 215 On OCT, optic disc drusen can be seen as a focal hyperreflective mass posterior to the outer plexiform and outer nuclear layers, with absence of the inner and outer segment photoreceptor junction (Figure 5); 112 however, Kulkarni et al found standard spectral-domain OCT (SD-OCT) to be unreliable at distinguishing between buried optic disc drusen and true optic disc edema in children and young adults. 104 They noted that, in several cases of mild disc edema, OCT showed nonspecific hyperreflective areas underneath the optic nerve that were confused with drusen.…”

Section: Diagnostic Testingmentioning

confidence: 99%

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Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

112

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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: Diagnostic Testingmentioning

confidence: 99%

Section: Diagnostic Testingmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

112

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“…20 The only previous report of drusen quantification in OCT was performed by Yi et al in a study which used an experimental SD-OCT device. 22 …”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, the only study which has attempted to quantify the size, shape, and location of ONHD used an experimental SD-OCT instrument. 22 Therefore, this study sought to determine if SS-OCT volume scans could be used to measure ONHD size, shape, and location.…”

Section: Introductionmentioning

confidence: 99%

Volumetric Measurement of Optic Nerve Head Drusen Using Swept-Source Optical Coherence Tomography

Tsikata

Verticchio

Falkenstein

et al. 2017

Journal of Glaucoma

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Purpose: To describe new software tools for quantifying optic nerve head drusen volume using 3-dimensional (3D) swept-source optical coherence tomography (SS-OCT) volumetric scans. Materials and Methods: SS-OCT was used to acquire raster volume scans of 8 eyes of 4 patients with bilateral optic nerve head drusen. The scans were manually segmented by 3 graders to identify the drusen borders, and thereafter total drusen volumes were calculated. Linear regression was performed to study the relationships between drusen volume, retinal nerve fiber layer thickness, and Humphrey visual field mean deviation. Results: In the 8 study eyes, drusen volumes ranged between 0.24 to 1.05 mm3. Visual field mean deviation decreased by ∼20 dB per cubic millimeter increase in drusen volume, and the coefficient of correlation of the linear regression was 0.92. In this small patient series, visual field defects were detected when drusen volume was larger than about 0.2 mm3. Conclusions: Software tools have been developed to quantify the size of OHND using SS-OCT volume scans.

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“…While this technique shows promise, it seems most effective in cases where surface ODD are clinically apparent; in more subtle cases, the distinguishing OCT features are less clear. Buried ODD can be detected with spectral-domain OCT (8), but differentiating ODD from ODE has yet to be established with this technique.…”

Section: Discussionmentioning

confidence: 99%

Fluorescein Angiographic Identification of Optic Disc Drusen With and Without Optic Disc Edema

Pineles

Arnold

2012

Journal of Neuro-Ophthalmology

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Background The fluorescein angiographic criteria for differentiating optic disc drusen (ODD) from optic disc edema have been unclear. We designed a study to identify distinguishing angiographic features of each and to apply them to cases where both drusen and edema were present. Methods A computer search was performed for cases evaluated in a university academic neuro-ophthalmology consultative practice and coded as ODD; all cases were reviewed, and those with fluorescein angiography were selected for further study. Cases were classified as either buried or surface ODD. Ten cases with papilledema were selected for comparison. Eight cases of coexistent drusen and edema were identified. Autofluorescence, early leakage, early blockage, early and late nodular staining, late peripapillary staining, and late leakage were tabulated. Results Two hundred sixteen cases of ODD were identified; 62 (116 eyes) had adequate fluorescein angiography for study. Twenty-three eyes were classified as surface ODD; 90% demonstrated early nodular staining of the disc, with late nodular staining in 90% and late circumferential peripapillary staining in 22%; autofluorescence was visible in 93% with preinjection photography. Eighty-three eyes were classified as buried ODD; 25% demonstrated early nodular staining, with late nodular staining in 29% and late circumferential peripapillary staining in 80%; autofluorescence was visible in 12% of those with preinjection photography. In 9 eyes, buried ODD were present with superimposed true edema. In these eyes, early dye leakage, late nodular hyperfluorescence, and late leakage were present. Conclusion Early and late fluorescein angiographic features reliably distinguish ODD from edema and may be particularly useful when the conditions coexist.

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Imaging of Optic Nerve Head Drusen

Cited by 48 publications

References 25 publications

Optic disk drusen in children

Optic disk drusen in children

Volumetric Measurement of Optic Nerve Head Drusen Using Swept-Source Optical Coherence Tomography

Fluorescein Angiographic Identification of Optic Disc Drusen With and Without Optic Disc Edema

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