Eyes with exposed drusen had significantly worse visual acuity and visual field outcome p drusen. 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. The pulfrich phenomenon in optic disc drusen british. Optic disc drusen prevalence of 2% usually manifest as bilateral calcified nodules within the optic nerve head, producing a lumpy optic disc appearance. Prevalence and histopathological signatures of optic disc. The optic disc drusen is a congenital optic disc anomaly which is formed by the accumulation of pathological calcified material in the hyaline structure on the optic disc. Another intent was to determine the sensitivity and correlations in. Nov 01, 20 optic nerve head drusen onhd or optic disc drusen odd occurs rarely in the population, about 1% of the population, though there seems to be a genetic association as in families with a history of onhd, it increases to almost 3.
We measured the vessel density vd of the optic disc in odd using optical coherence tomography angiography and compared it with a normal population. Optic nerve drusen can be verified a number of ways in your eye doctors office or at a specialist. Optic disc drusen odd is hyaline deposits in the optic nerve head seen in 12% of the population. Eyes with exposed drusen had significantly worse visual acuity and visual field outcome p pdf. The high prevalence of optic disc drusen after papilloedema has resolved. Within the optic nerve, the hyaline bodies are confined anterior to the lamina cribrosa and can compress and compromise the nerve fibers and vascular supply, leading to visual field defects and disc hemorrhages. Optic disc drusen risks, symptoms and leading causes treato. Optical coherence tomography oct can aid in the differential diagnosis of optic nerve head onh elevation. Abstract optic disc drusen odd represent a frequent cause of slowly progressive optic neuropathy. Optic disc drusen odd are acellular deposits located in the optic nerve head of. In threequarters of cases they appear in both eyes. Optic disc drusen are congenital and developmental anomalies of the optic nerve head seen commonly in clinical practice, often as an incidental ophthalmologic finding during routine exams. Oct, ct scan, but the most common way to verify optic nerve drusen is to use a b scan.
Optic disc drusen odd constitute an important source of vision loss and present unique clinical challenges. Purpose optic disc drusen odd are calcified optic nerve head deposits. Familial drusen are inherited as an autosomal dominant trait, which means your mother or father or child is likely to. Optic disc drusen is characterized as abnormal deposits of proteinlike material within the optic nerve head. They may develop as byproducts of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Evidence suggests axoplasmic transport alteration and axonal degeneration are involved in disc drusen formation.
When buried, the main clinical significance of drusen is theirresemblance to true papilledema. Sir, optic disc swelling in a child, with no other features suggestive of raised intracranial pressure is a challenging clinical. Optic disc drusen your doctor has diagnosed you with optic disc drusen. Detection of optic disc drusen in children using ultrasound. As it exits the back of the eye, the optic nerve head normally appears as a yellowpink circle with a discrete round edge. Common symptoms reported by people with optic disc drusen. Oct 16, 2008 optic disc drusen are acellular calcific deposits occurring in small, crowded optic discs with abnormal vasculature. No treatment is needed for most causes of pseudopapilledema because they represent normal physiologic variants. Buried optic disc drusen are harder to visualize and the optic disc may have a variable appearance ranging from normal to pseudopapilledematous. They are thought to be the remnants of the axonal transport system of degenerated retinal ganglion cells. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years.
Optic disc drusen odd are globules of mucoproteins and mucopolysaccharides that progressively calcify in the optic disc. Anterior ischemic optic neuropathy in eyes with optic disc drusen. We report herein three cases referred to us with suspicion of. Optic disc drusen usually do not show up in infants. An irregular knobbly disc margin, anomalous branching of the vessels and autofluorescence help clinical differentiation from papilloedema. Pdf bilateral optic disc drusen mimicking papilledema. A 44yearold woman with progressive monocular visual loss was found to have ipsilateral optic disc drusen and an ipsilateral orbital apex mass compressing the optic nerve.
Over time these deposits calcify in the optic disc and may affect peripheral vision. Odd are contained within the optic nerve above the lamina cribrosa and usually below the plane of bruch membrane. In affected patients, the number and size of disc drusen are highly variable, and the drusen may be visible near the disc surface or buried within the disc, causing. They consist of acellular concretions of calcium, amino and nucleic acids, mucopolysaccharides, and sometimes iron. Diseases possibly associated with disc drusen may need treatment, such as subretinal neovascular membrane, central retinal vein occlusion, or ischemic optic neuropathy largely to exclude giant cell arteritis in the appropriate age groups. The optic nerve is the physical connection between the eye and the brain. Drusen are small yellow deposits of fatty proteins lipids that accumulate under the retina the retina is a thin layer of tissue that lines. All the visual information taken in by the eye is transmitted to the brain along the optic nerve. Patients diagnosed with optic disc drusen should consider discussing their diagnosis with their family members so that they undergo screening evaluation.
Optic nerve head drusen onhd or optic disc drusen odd occurs rarely in the population, about 1% of the population, though there seems to be a genetic association as in families with a history of onhd, it increases to almost 3. The optic nerve head, or optic disc is the anterior end of the nerve that remains in the eye and for this reason shows up with an ophthalmoscope. Detection of optic disc drusen in children using ultrasound through the lens and avoiding the lenspoint of care ultrasound technique of evaluation revisited renuka rajagopal 1, ellen mitchell 1, christin sylvester 1,2, lea ann lope 1 and ken kanwal nischal 1,2, 1 upmc eye center, upmc childrens hospital of pittsburgh, pittsburgh, pa. Sir, optic disc swelling in a child, with no other features suggestive of raised intracranial pressure is a challenging clinical scenario.
Optic disc drusen are abnormal deposits of proteinlike material in the optic disc the front part of the optic nerve. Optic disc drusen, which are calcified deposits that form anterior to the lamina cribrosa in the optic nerve, may mimic papilledema. Jan 08, 2019 drusen are small yellow deposits of fatty proteins lipids that accumulate under the retina the retina is a thin layer of tissue that lines the back of the inside of the eye, near the optic nerve. Studies of several large series of patients with pseudopapilledema with or without optic disc drusen have documented the clinical findings in adulthood. Visible optic disc drusen appear as refractile, whitish yellow, rounded crystalline deposits embedded within the optic nerve head. Specific oct hallmarks, such as v contour and a lumpybumpy appearance, associated with optic disc edema and optic nerve head drusen, respectively, were investigated in isolation from line scans added to photographs of various elevated onhs in a webbased survey. Differentiating optic disc edema ode caused by papilledema or other optic neuropathies from optic nerve head drusen onhd is important clinically but can be difficult even with fluorescein angiography, bscan ultrasonography, and computed tomography. Ct of drusen bodies and other calcific lesions of the.
Bmode ultrasound and autofluorescence study were performed, which confirmed the presence of optic disc drusen odd bilaterally. The use of oct in differential diagnosis of elevated optic. Optic disc drusen are a form of calcific degeneration in some of the axons of the optic nerve. Optic nerve drusen are often inherited, but people without a family history. I have also recently been diasgnosed with optic disc drusen. Optic disc drusen an overview sciencedirect topics. Yes, optic disc drusen can occur as an inherited family trait and may affect close relatives.
It may be difficult to distinguish optic nerve drusen from progressing glaucoma as the cause based solely on visual field testing davis 2003, auwhaedrich 2002. The mass, not the drusen, was considered responsible for the worsening vision. Objectives of this study were to examine the prevalence of odd in eyes removed by enucleation and to describe related histopa. The patients guide to optic nerve drusen eyedolatry. Optic disc drusen masquerading as papilloedema archives. Optic nerve drusen visual field loss ophthalmology.
Optic nerve drusen is also known as optic disc drusen orpseudopapilledema. Bilateral optic disc drusen mimicking papilloedema. Anterior ischemic optic neuropathy in eyes with optic disc. Sep 04, 2019 while papilledema is disc edema secondary to increased intracranial pressure, optic disc drusen also known as pseudopapilledema and optic nerve head drusen represent apparent optic disc swelling that simulates some features of papilledema but is secondary to an underlying, usually benign, process. Apr 25, 2018 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. Optic disc drusen occur in about 1% of the population and are found more frequently in caucasians. Optic disc drusen odd are acellular deposits located in the optic nerve head of up to 2. Optic disc drusen may be inherited or may occur without any family history. A b scan is an ultrasound test that is used over top of the patients closed eyelid, that will show the buried drusen quite distinctly as small reflective. The optic nerve represents the cable connecting the eye to the brain, carrying all of the information from the retina that we need to see. The average age that it first appears is 12 years old. Odd result probably from an abnormal axonal metabolism, leading to mitochondrial calcification at the level of the lamina cr. Progressive visual failure in an eye with optic disc drusen. Fundus fluorescein angiography showed no evidence of papilloedema.
Glaucoma today optic disc drusen januaryfebruary 2012. It includes over one million retinal ganglion cell axons. Over the years, optic disc drusen have been referred to by various names, including pseudopapilledema, buried disc drusen, and anomalous discs. This was afer 2 years of going backwards and forwards and being told lets put it down to something that happened in pregnancy i was also referred to a neurologist to rule out other possibilites. Confirmation by ultrasound or ct scan is possible, since such discs are calcified. The optic disc drusen studies consortium recommendations for diagnosis of optic disc drusen using optical coherence tomography article pdf available in. The optic nerve is a cable tube connection that transmits images from the retina to the brain. Optic disc drusen are hyaline bodies in the optic nerve head of unknown aetiology,1 which are present in approximately 2% of the population. In a large study of patients with rp, the incidence of disc drusen has been documented to be as high as 10%. It develops slowly as material collects on the optic nerve head. Pdf central retinal artery occlusion and optic disc drusen.
Unlike drusen found in the macula, optic disc drusen are globules of mucoproteins that calcify in the optic disc. Epidemiology optic disc drusen are identified radiographically in up to 0. Drusen are deposits of the optic nerve head present in 03% of the population, of which 70% occur bilaterally. Optic disc drusen odd are a relatively common congenital disc anomalyfound in up to 2% of the population. The incidence of retinal hemorrhage is between 2% and 10. Most cases of subretinal neovascularization associated with optic disc drusen resolve without treatment and with only mild symptoms.
Differentiating optic disc edema from optic nerve head drusen. We do not know the exact cause of optic disc drusen but they are thought to come from abnormal flow of material in optic nerve cells. Optic disc drusen odd, or hyaline bodies, are a relatively common entity usually found incidentally on ct or on followup of abnormal fundoscopy. Optic nerve drusen are abnormal collections of proteins and calcium salts which accumulate in the optic nerve. Background optic disc drusen odd can cause retinal nerve fibre layer rnfl defects with progressive visual field vf loss. Based on longterm clinical data and optical coherence tomography, we propose a refined hypothesis as to the cause of optic disc drusen. Ct of drusen bodies and other calcific lesions of the optic nerve.
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