Bilateral Optic Disc Drusen Research Articles

Drusen de la tête du nerf optique ou œdème papillaire ?

Bilateral optic disc drusen can mimic papilledema, raising the question of intracranial hypertension and sometimes prompting unnecessary or invasive procedures. Optic disc drusen are benign calcified masses, often visible within the optic nerve head. However, their clinical diagnosis can be more difficult at earlier stages of life, when they are buried within the optic nerve. Visual field loss can occur in patients with longstanding optic disc drusen. Ophthalmoscopy and B-scan ocular ultrasonography allow appropriate diagnosis of bilateral optic disc drusen mimicking papilledema. On rare occasions, optic disc drusen can be associated with ischemic complications, the other causes of drusen-related visual loss being exceptionally rare.

Vascular Shunt of the Optic Disc Resembling Neovascularization in a Diabetic patient with Optic Disc Drusen

To report an insulin-dependent diabetic patient who was referred by the diabetic screening clinic as having proliferative diabetic retinopathy who was found to have bilateral optic disc drusen with optociliary shunt resembling neovascularization on the disc. Complete ocular evaluation including a fluorescein angiography was performed. Fundus examination showed signs of mild nonproliferative diabetic retinopathy in the right eye and the presence of well-defined optic disc drusen in both eyes with a peculiar vascular abnormality resembling neovascularization on the right disc. The central retinal vein pulsation was normal on digital examination. Autofluorescence confirmed the presence of the optic disc drusen in both eyes. Fluorescein angiography showed no leakage from the optociliary shunt. The vascular abnormality has remained stable for 2 years. This case highlights the correlation of optic disc drusen and optociliary shunts which in diabetic patients can be misdiagnosed as neovascularization.

Bilateral optic disc drusen with severe progressive visual field defect

We report a 17-year, 9-month-old Japanese boy who presented bilateral optic disc drusen with severe progressive visual dysfunction. Static perimetry showed progressive visual field defects, especially in the right eye. The corrected visual acuity in the right eye was 20/20 at the first examination, but decreased to 20/400 during the follow-up period. It remained 20/20 in the left eye. The appearance of the optic disc changed during the follow-up period. The deterioration of the visual function may have been related to growth of the optic disc drusen and/or a regressive change in the vasculature.This patient is the youngest yet reported to have shown this condition, and his visual field defects showed particularly severe deterioration.

Optic disc drusen associated with angioid streaks

Purpose: To emphasize the importance of the association of optic disc drusen (ODD) with angioid streaks (AS). Methods: Three patients with ODD and AS underwent a thorough ophthalmic examination including perimetry and B-scan ultrasonography. Fundus fluorescein angiography was performed when indicated. Results: Bilateral ODD associated with AS were present in all of the cases. Pseudoxanthoma elasticum was the definite etiology of the AS in two cases, one of which was complicated by subretinal neovascularization. Laser photocoagulation resulted in closure of the membrane. Conclusions: The follow-up of patients with ODD with regard to the development of AS is essential as ODD may be the earliest clinical manifestation in patients with pseudoxanthoma elasticum, which has potential vision- and life-threatening complications.

Are optic disc drusen inherited?

ObjectiveTo conduct family studies of the incidence of optic disc drusen and related optic disc anomalies among relatives of those affected. DesignRetrospective case series with prospective examination of patients and their relatives using B-scan ultrasonography and color photography. ParticipantsA total of 27 relatives of 7 probands with bilateral optic disc drusen were examined. Main outcome measuresPresence of optic disc drusen on clinical examination or B-scan ultrasonography and presence of related anomalies, including absence of optic disc cup and presence of anomalous vasculature. ResultsOnly 1 of 27 relatives had optic disc drusen (3.7%). Thirty of 53 eyes had anomalous vessels (57%), and 26 eyes had no optic cup (49%). ConclusionThe primary pathology of optic disc drusen is likely to be an inherited dysplasia of the optic disc and its blood supply, which predisposes to the formation of optic disc drusen.