The Optic Nerve
Superficial optic nerve drusen demonstrating autofluorescence.
Optic Nerve Drusen

  • Clinical features:
    • Symptoms: mostly asymptomatic, but may present with visual field defects, decreased visual acuity, or transient obscuration of vision.
    • Signs:
      • Discrete, multiple, amorphous or partly calcified hyaline bodies located anterior to the lamina cribrosa
      • The bodies may be superficial or buried within the optic disc (typically in the nasal region)
      • Buried hyaline bodies in children or young people may simulate papilledema
      • Superficial drusen appear as autofluorescent bodies that are visible on fundus photographs using appropriate filter prior to fluorescein dye injection
      • As the progression of the drusen interferes with the blood supply of the optic nerve, several conditions may result:
        • Acute swelling of the optic nerve
        • Splinter hemorrhage
        • Ischemic optic neuropathy
  • Fluoresecein angiography:
    • Undilated capillary network with no leakage of dye into the peripapillary region.
    • Discrete foci of hyperfluorescence with late staining of the drusen.
  • B-scan ultrasound is helpful in detecting buried drusen.
  • Associated ocular findings include Retinits Pigmentosa, angioid streaks in patients with or whithout pseudoxanthoma elasticum, Usher's syndrome and X-linked retinoschisis.

Copyright © 2003 Digital Reference of Ophthalmology. All rights reserved. All material published on this website is the property of Digital Reference of Ophthalmology and cannot be duplicated without permission.
Home Search Home Search