The aim of this study was to evaluate and compare 10-MHz and 20-MHz ultrasonography in the assessment of patients with optic nerve head drusen (ONHD). The design of the study was prospective, comparative and cross-sectional. Ultrasonographic examination with a 10 and 20MHz probe was performed in 45 eyes with suspected ONHD. The 20MHz probe showed drusen in 43 eyes (95.5%), while the 10MHz probe revealed drusen in only 33 eyes (73.3%, p=0.0001). The 10MHz probe showed surface drusen in 10 eyes (22.2%), while the 20MHz probe showed surface drusen in 14 eyes (31.1%) (sensitivity 71.4%; 95% CI [47.6-95.1%]). The 10MHz probe showed buried drusen in 23 eyes (23.1%), while the 20MHz probe showed buried drusen in 29 eyes (64.4%) (sensitivity 79.3%; 95% CI [56.6-86.2%]). The sensitivity was 76.7% with 10MHz probe compared to a 20MHz as gold standard. The use of 20MHz probe increased the sensitivity of buried disc drusen by 1.5 times and surface disc drusen by nearly 2 times. Using the 10MHz probe alone the false negative error rate was 83.3%. The 20MHz probe has shown itself to be an excellent method for the diagnosis of ONHD; it is more sensitive and reliable than 10MHz probe and should be considered in the management of patients with clinical evidence of ONHD.
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