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

2016 ◽  
Vol 27 (3) ◽  
pp. 372-378 ◽  
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.

scholarly journals Factors associated with visual field defects of optic disc drusen

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0196001 ◽  
Author(s):  
Kyoung Min Lee ◽  
Se Joon Woo ◽  
Jeong-Min Hwang
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Visual Field Defects ◽  
Factors Associated ◽  
Optic Disc Drusen ◽  
Field Defects

scholarly journals Central Visual Field Defects in Patients with Distinct Glaucomatous Optic Disc Phenotypes

2021 ◽  
Vol 223 ◽  
pp. 229-240
Author(s):  
Eren Ekici ◽  
Sasan Moghimi ◽  
Huiyuan Hou ◽  
James Proudfoot ◽  
Linda M. Zangwill ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Visual Field Defects ◽  
Central Visual Field ◽  
Field Defects

Automated Perimetry in Glaucoma

Visual Fields ◽  
2010 ◽  
Author(s):  
Hylton R. Mayer ◽  
Marc L. Weitzman
Keyword(s):  
Optic Nerve ◽  
Visual Field ◽  
Nerve Fiber ◽  
Optic Disc ◽  
Structural Damage ◽  
Visual Field Defects ◽  
Fiber Layer ◽  
Glaucomatous Damage ◽  
Retinal Fibers ◽  
Field Defects

Clinical experience and multiple prospective studies, such as the Collaborative Normal Tension Glaucoma Study and the Los Angeles Latino Eye Study, have demonstrated that the diagnosis of glaucoma is more complex than identifying elevated intraocular pressure. As a result, increased emphasis has been placed on measurements of the structural and functional abnormalities caused by glaucoma. The refinement and adoption of imaging technologies assist the clinician in the detection of glaucomatous damage and, increasingly, in identifying the progression of structural damage. Because visual field defects in glaucoma patients occur in patterns that correspond to the anatomy of the nerve fiber layer of the retina and its projections to the optic nerve, visual functional tests become a link between structural damage and functional vision loss. The identification of glaucomatous damage and management of glaucoma require appropriate, sequential measurements and interpretation of the visual field. Glaucomatous visual field defects usually are of the nerve fiber bundle type, corresponding to the anatomic arrangement of the retinal nerve fiber layer. It is helpful to consider the division of the nasal and temporal retina as the fovea, not the optic nerve head, because this is the location that determines the center of the visual field. The ganglion cell axon bundles that emanate from the nasal side of the retina generally approach the optic nerve head in a radial fashion. The majority of these fibers enter the nasal half of the optic disc, but fibers that represent the nasal half of the macula form the papillomacular bundle to enter the temporal-most aspect of the optic nerve. In contrast, the temporal retinal fibers, with respect to fixation, arc around the macula to enter the superotemporal and inferotemporal portions of the optic disc. The origin of these arcuate temporal retinal fibers strictly respects the horizontal retinal raphe, temporal to the fovea. As a consequence of this superior-inferior segregation of the temporal retinal fibers, lesions that affect the superotemporal and inferotemporal poles of the optic disc, such as glaucoma, tend to cause arcuateshaped visual field defects extending from the blind spot toward the nasal horizontal meridian.

scholarly journals Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

2014 ◽  
Vol 67 (5-6) ◽  
pp. 185-189
Author(s):  
Marija Trenkic-Bozinovic ◽  
Predrag Jovanovic ◽  
Gordana Zlatanovic ◽  
Dragan Veselinovic ◽  
Aleksandra Aracki-Trenkic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Ganglion Cells ◽  
Therapeutic Interventions ◽  
Visual Field Defects ◽  
Retinal Hemorrhages ◽  
Optic Disc Drusen

Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

Sign in / Sign up

Export Citation Format

Share Document