Optic Disc Drusen in Children: The Copenhagen Child Cohort 2000 Eye Study

Self Cite

The aim was to analyse the optic disc angioarchitecture in optic disc drusen (ODD) patients using computer-based fundus analysis in a case-control study. Compared with controls the ODD group had a significantly more centralised central retinal artery (CRA) emergence (p < 0.001) and primary CRA branching (p = 0.008), a higher number of CRA bifurcations (p = 0.02), a larger vertical optic disc diameter (p = 0.02) and a smaller cup/disc ratio (p < 0.001). The CRA emergence was largely within the nasal zone for both groups. The distinctive angioarchitecture of the optic disc in ODD patients can play a role in understanding the pathogenic cause of ODD.

Section: Discussionmentioning

confidence: 99%

The Angioarchitecture of the Optic Nerve Head in Patients with Optic Disc Drusen

Vahlgren

Malmqvist

Rueløkke

et al. 2019

Self Cite

“…39 As an additional distinguishing OCT feature, Bruch's membrane layer opening measures have been shown to be smaller in ODD eyes relative to eyes affected by papilloedema. In the Copenhagen Child Cohort Eye Study, 40 children with ODD had narrower scleral canal openings, relative to control subjects. Yet, a study of adults revealed larger scleral canal sizes in individuals with ODD relative to control eyes.…”

Section: Using Oct To Distinguish Odd From Papilloedema: Putting Prinmentioning

confidence: 94%

Diagnosing Optic Disc Drusen in the Modern Imaging Era: A Practical Approach

Costello

Rothenbuehler

et al. 2020

Optic disc drusen (ODD) are a well-recognised cause of an elevated optic disc appearance. When visible with ophthalmoscopy and fundus photography, ODD are readily identified. Yet, in more subtle cases of ODD, ancillary testing may be needed to render the diagnosis. Facilitating the diagnosis of ODD has clinical relevance, because affected individuals may otherwise undergo unnecessary costly and invasive investigations to rule out raised intracranial pressure and other causes of optic disc oedema. In this review, the role of established and emerging optical coherence tomography (OCT) techniques in the diagnosis and management of ODD cases is reviewed. A practical approach is taken to explain how to optimise use of commercially available OCT technology in the clinical setting. Optical coherence tomography provides many advantages over other imaging modalities in the diagnosis of ODD, including the ability to correlate retinal measures of neuroaxonal structure with drusen characteristics. Earlier spectral domain OCT techniques, however, were hindered by poor penetrance. In the modern imaging era, enhanced depth imaging OCT and swept source OCT enable higher resolution of ODD and other optic nerve head structures that might otherwise be mistaken for drusen. Ongoing studies featuring OCT angiography indicate that this technique may provide complementary information about microvascular supply that correlate with structural measures of optic nerve injury. Advances in OCT will continue to improve diagnostic accuracy and inform clinical understanding regarding structure-function correlations germane to the longitudinal follow up of ODD patients.

“…The clinical prevalence of ONHD has been consistently estimated at 0.3-0.5% in adults and in children. 18,24,[29][30][31][32][33] The similar prevalence between children and adults indicates that drusen do not develop or change greatly after the first decade of life (see more in visual function, below). However with histological analysis, the autopsy prevalence is up to seven times higher at 2%.…”

Section: Diagnosis Of Onhd In the Populationmentioning

confidence: 96%

“…56 In 11-12-year children, 92% of those with ONHD had a smaller scleral canal on EDI-OCT (below 25th percentile), and it was suggested that ONHD may arise in a small canal but then cause remodelling of the canal during growth into adulthood, as well as measurement artefacts. 33 Thus, some of the previously reported differences in optic disc size may relate to the relative appearance of discs with ONHD and the way in which ONHD have been clinically detected in the past. 62…”

Section: Small Scleral Canalmentioning

confidence: 99%

“…56 A representative cohort of Danish 11-12-year children were examined by EDI-OCT and a prevalence of 1.0% was reported (1.8% if the hyper-reflective bands were included as ONHD). 33 A recent study by Traber and colleagues described three types of ONHD on OCT: (1) the 'subretinal' peripapillary hyper-reflective bulges described on early OCT reports, (2) hyper-reflective bands ('granular' ONHD), and (3) larger 'confluent' ONHD with a hyporeflective core. 2 In this cohort, half of those with buried drusen and no visual field defect were diagnosed based only on the presence of these subretinal lesions, so misclassification may limit some of their conclusions.…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

See 1 more Smart Citation

Optic Nerve Head Drusen: An Update

Palmer

Gale

Crowston

et al. 2018

Optic nerve head drusen are benign acellular calcium concretions that usually form early in life, just anterior to the lamina cribrosa. Improving imaging using optical coherence tomography suggests they are common and may be present in many clinically normal discs. These drusen may change in appearance in early life, but are generally stable in adulthood, and may be associated with visual field defects, anterior ischaemic optic neuropathy, or rarer complications. Based on long-term clinical data and optical coherence tomography, we propose a refined hypothesis as to the cause of optic disc drusen. Here we summarise recent findings and suggest future studies to better understand the forces involved.