Microvascular Changes Associated with Optic Disc Drusen: Case Report

BackgroundOptic disc drusen (ODD) can cause retinal nerve fibre layer (RNFL) defects with progressive visual field (VF) loss. Microvascular changes are discussed as a cause. We measured the vessel density (VD) of the optic disc in ODD using optical coherence tomography angiography and compared it with a normal population. Another intent was to determine the sensitivity and correlations in comparison with functional (VF) and structural parameters (RNFL, minimum rim width (MRW), ganglion cell complex (GCC)).MethodsWe analysed the VD of 25 patients with ODD and an age-matched control population including 25 healthy participants using AngioVue (Optovue, Fremont, CA, USA). We obtained data about RNFL, GCC, Bruch’s membrane opening MRW (Spectralis HRA & OCT; Heidelberg Engineering, Germany) and VF (standard automated perimetry; SITA 24-2). Low image quality and pathologies interfering with the diagnostics were excluded. Parametric data were analysed using the t-test and non-parametric values using the Mann-Whitney U test. Linear regression analysis was used to determine correlations using the Bravais-Pearson test.ResultsThe VD was significantly reduced in the ODD group especially the peripapillary capillary VD (n=45 vs 50 eyes; mean 43.15% vs 51.70%). Peripapillary RNFL thickness correlated with the VD significantly (r=0.902 (n=44), 0.901 (n=44), 0.866 (n=45)). The RNFL analysis showed a reduction in ODD, especially the superior hemisphere (mean 107 µm, 129 µm; 49 vs 50 eyes). The GCC was significantly lower in the ODD group (n=38 vs 40; mean 87 µm vs 98 µm). Positive correlation between the VD and the GCC was significant (n=37, r=0.532). There is a significant negative correlation (n=19; r=−0.726) between the VD and the pattern standard deviation (PSD).ConclusionThis study reveals significant peripapillary microvascular changes in patients with ODD correlating with the RNFL and GCC reduction. There is a negative correlation between the PSD and the VD.

Download Full-text

Bilateral Anterior Ischaemic Optic Neuropathy Due to Optic Disc Drusen

European Journal of Ophthalmology ◽

10.1177/112067210001000414 ◽

2000 ◽

Vol 10 (4) ◽

pp. 341-343 ◽

Cited By ~ 12

Author(s):

G.G. Kamath ◽

S. Prasad ◽

R.P. Phillips

Keyword(s):

Case Report ◽

Optic Disc ◽

Optic Neuropathy ◽

Optic Disc Drusen ◽

Ischaemic Optic Neuropathy ◽

Underlying Causes ◽

Anterior Ischaemic Optic Neuropathy ◽

Left And Right ◽

Optic Discs

Purpose To report a case of bilateral anterior ischaemic optic neuropathy due to buried optic disc drusen. Methods Case report. Results A 64-year-old man presented with swollen optic discs and features suggestive of anterior ischaemic optic neuropathy (AION) in the left and right eye on two separate occasions ten months apart. Detailed ocular examination at presentation and systemic investigations did not reveal an underlying cause for the AION. At a later follow-up, optic disc drusen were noted in both eyes as partial optic atrophy had set in. This was confirmed by ultrasound B scan and demonstration of autofluorescence. Conclusions In patients presenting with AION uncommon underlying causes must be considered. Routine ultrasound B scan at presentation can easily establish or exclude optic disc drusen as an underlying cause.

Download Full-text

A Case of a Young Asymptomatic Woman with Optic Disc Drusen and Vasculitis

Case Reports in Ophthalmology ◽

10.1159/000329715 ◽

2011 ◽

Vol 2 (2) ◽

pp. 232-237

Author(s):

Tryfon Rotsos ◽

Chrysanthos Symeonidis ◽

Mrinal Rana ◽

James S. Deane

Keyword(s):

Optic Disc ◽

Asymptomatic Woman ◽

Optic Disc Drusen

Download Full-text

Juxtapapillary Choroidal Neovascular Membrane as a Complication of Optic Disc Drusen

Journal of Neuro-Ophthalmology ◽

10.1097/wno.0000000000001227 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Vivian Paraskevi Douglas ◽

Konstantinos A. A. Douglas ◽

John B. Miller ◽

Dean M. Cestari

Keyword(s):

Optic Disc ◽

Choroidal Neovascular Membrane ◽

Optic Disc Drusen

Download Full-text

Optic Disc Drusen: Longitudinal Aspects, with Emphasis on Visual Field Constriction and Enlarged Blind Spot: A Retrospective Hospital-Based Clinical Series

European Journal of Ophthalmology ◽

10.5301/ejo.5000864 ◽

2016 ◽

Vol 27 (3) ◽

pp. 372-378 ◽

Cited By ~ 2

Author(s):

Hans C. Fledelius

Keyword(s):

Visual Field ◽

Optic Disc ◽

Blind Spot ◽

Observation Time ◽

Main Trend ◽

Visual Field Defects ◽

Optic Disc Drusen ◽

Clinical Series ◽

Field Defects ◽

Visual Field Constriction

Purpose To examine long-term data on optic disc drusen (ODD) from an outpatient hospital series that indicated more cases with advanced visual field constriction than is apparent from other clinical reports. The underlying pathophysiology is discussed, also with regard to enlarged blind spot, which, in view of the small disc at risk, may seem a paradox. Methods This is an observational retrospective study on an eye clinic series (n = 49), focusing on visual acuity, kinetic/static perimetry, and longitudinal trends, to include the question of eventual visual incapacity. Results Forty-nine patients (32 female and 17 male; bilateral ODD in 45) aged 5-76 years (median age 29 years for both sexes) were included in the study. Observation time was 1-54 years, with serial data recorded over at least 3 years in 25 patients. Visual field defects were found in 32 patients, with ODD considered responsible for the visual field defects demonstrated. Advanced unilateral concentric constriction (for the largest Goldmann object) was recorded in 10 patients, and bilaterally in 2. With regard to nonexplanatory side diagnoses, 2 patients had pituitary adenoma, 1 had a cavernous sinus meningioma, and 1 had neurosurgery for an arachnoid cyst. Conclusions We found more cases of marked visual field constriction than reported in other clinical series. A few such cases appeared acute and vascular, but the main trend was clinically quiet over time. All 49 patients could manage visually in daily life.

Download Full-text