- 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.
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