Optic Nerve Head Drusen

Bec, Pierre

doi:10.1001/archopht.1984.01040030536010

Cited by 24 publications

(3 citation statements)

References 16 publications

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“…However, deep and hidden drusen can be difficult to differentiate from true papillary oedema. Several diagnostic methods for ODD have been described: exploration of the eye fundus [9], autofluorescence [10], fluorescein angiography [11], ocular ultrasound [12], computed tomography [13] and, more recently, optical coherence tomography [14,15]. Since its emergence in the early 1980s, B-scan echography has been considered the gold standard for the diagnosis of ODD [16,17].…”

Section: Introductionsupporting

confidence: 46%

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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Section: Introductionsupporting

confidence: 46%

Ophthalmic Features of Optic Disc Drusen

2012

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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%

“…12; 82; 105; 131; 162; 217 Like B-scan ultrasonography, CT detects calcification of drusen. It is limited by the 1.5 mm thickness of slices, which may miss drusen, and has been shown to be inferior to ultrasonography.…”

Section: Diagnostic Testingmentioning

confidence: 99%

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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