Optic nerve Drüsens in black patients: a case series of 16 patients

Abstract

PurposeOptic nerve Drüsens are rare among black patients. The goal of our study was to describe the characteristics of ophthalmological findings in this population.MethodsWe carried out a descriptive prospective study from June 2006 to October 2014 on 19 eyes of Afro‐Caribbean patients from Martinique with optic nerve Drüsens diagnosed by fundoscopy and B‐Scan ultrasonography. Patients underwent clinical exam, Optical coherence tomography (OCT), colour vision, and visual field. Three eyes were excluded from visual acuity and paraclinic analysis due to an anterior optic ischemic neuropathy (AOIN), a penetrating eye injury and an epimacular membrane.Results11 Afro‐Caribeean patients were included: four men and seven women with age ranking from 11 to 68 years with a mean age of 41. Nine of the 11 patients (69%) had bilateral optic nerve Drüsens. Only 2 patients (12%) were symptomatic including the AOIN. Mean ETDRS visual acuity was 56 at 4 meters (min 31, max 68, sd 7.0). Three of 16 eyes (19%) had an ETDRS vision loss. Four of 16 (25%) had a Pellirobson contrast vision loss due to cataracts. Four patients (25%) had a dyschromatopsy. The average OCT RNFL was 94 µm (min 57, max 150, sd 18.7). Mean foveal threshold was 34 db (min 22, max 39; sd 2.8). 11 of 16 eyes (69%) showed a visual field defect: Nine had an enlarged blind spot and nine had an arcuate scotoma. None of the patients had a pathology associated with optic nerve Drüsens such as pigmentary retinopathy or angioïd streaks.ConclusionsThis study is the largest case series carried out on optic nerve Drüsens in black patients. It shows that the majority of them is asymptomatic but campimetric defects are common. Some rare but severe complications can occur such as AION.