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Viana AR, Pereira S, Lemos A, Basto R, Correia Barbosa R, Reis da Silva A. Visual Field Defects in Patients With Optic Nerve Head Drusen. Cureus 2023; 15:e51317. [PMID: 38288170 PMCID: PMC10823312 DOI: 10.7759/cureus.51317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Background Optic nerve head drusen (ONHD) are acellular deposits in the optic nerve head, whose pathophysiology remains not fully understood. Most patients with ONHD have visual field (VF) defects. This study aims to describe the VF defects observed in patients with ONHD and to compare the anatomical and functional impairment between visible and buried ONHD. Methods Patients with ONHD were retrospectively studied. The retinal nerve fiber layer (RNFL) average thickness and the ganglion cell complex (GCC) average thickness were collected from optical coherence tomography data. Visual field index (VFI), mean deviation (MD), and pattern standard deviation (PSD) were collected from 30-2 standard automated perimetry. An abnormal VF test was defined as having a Glaucoma Hemifield Test outside normal limits and/or a PSD with a p-value<5%. Eyes with superficial or buried ONHD based on visibility by slit-lamp ophthalmoscopy were compared. Results Sixty-six eyes of 36 patients were included in the study. The mean age was 39.6 ± 2.5 years. Forty-nine eyes (81.7%) presented a VF defect: concentric VF constriction in 19 (38.8%), arcuate scotoma in 16 (32.7%), enlarged blind spot in 9 (18.4%), unspecific VF defect in 8 (16.3%), and nasal step in 3 (6.1%). Thirty-four eyes (51.5%) had superficial ONHD and 32 eyes (48.5%) had buried ONHD. Patients with superficial ONHD were significantly older (p<0.001) and presented a significantly lower VFI (p=0.010), lower MD (p=0.002), higher PSD (p<0.001), thinner GCC (p<0.001), and thinner RNFL (p<0.001) than patients with buried ONHD. VF defects were present in 90.6% of eyes with superficial ONHD and 71.4% of eyes with buried ONHD (p=0.113). The type of VF defects differed between groups (p=0.020). Conclusions Functional and structural impairment is more evident in eyes with superficial ONHD, maybe because the presence of calcification leads to greater axonal damage. Buried ONHD is more prevalent in younger patients, progressing to a superficial location and becoming calcified with age.
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Affiliation(s)
- Ana Rita Viana
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
| | - Sara Pereira
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
| | - Alberto Lemos
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
| | - Rita Basto
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
| | - Renato Correia Barbosa
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
| | - Alexandre Reis da Silva
- Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, PRT
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Antonelli G, Ziccardi L, Barbano L, Di Renzo A, Parisi V. Morpho-Functional Assessment of Retinal Ganglion Cells and Visual Pathways in Patients with Optic Disc Drusen: Superficial Drusen Visible Height as a Marker of Impairment. J Clin Med 2023; 12:jcm12103432. [PMID: 37240544 DOI: 10.3390/jcm12103432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to assess the morpho-functional involvement of the retinal ganglion cells (RGCs) and of the visual pathways in patients with superficial (ODD-S) or deep (ODD-D) optic disc drusen. This study enrolled 17 patients with ODD (mean age of 59.10 ± 12.68 years) providing 19 eyes and 20 control subjects (mean age 58.62 ± 8.77 years) providing 20 eyes. We evaluated the following: best-corrected visual acuity, visual field mean deviation (MD), the amplitude (A) of Pattern Electroretinogram (PERG), the implicit time (IT) and A of Visual Evoked Potentials (VEPs), retinal nerve fiber layer thickness (RNFL-T) and ganglion cell thickness (GC-T). In ODD-S eyes, the drusen visible height was measured. ODD-D and ODD-S were detected in 26.3% and 73.7% of ODD eyes, respectively. Significantly (p < 0.01) reduced MD, PERG A, VEP amplitude, RNFL-T and GC-T values and significantly (p < 0.01) increased VEP IT values were found in the ODD Group as compared to the Control one. In the ODD Group, no significant correlation (p > 0.01) between PERG As and VEP ITs was found. In ODD-S, the visible height was significantly correlated (p < 0.01) with reduced MD, PERG As and RNFL-T and with increased PSD and VEP IT values. Our findings suggest that ODD might induce morpho-functional changes in RGCs and their fibers and an unrelated visual pathway dysfunction leading or not leading to visual field defects. The observed morpho-functional impairment should be ascribed to an alteration in retrograde (from the axons to the RGCs) and anterograde (from the RGCs up to the visual cortex) axoplasmic transport. In ODD-S eyes, a minimum visible height of 300 microns represented the threshold for the abnormalities, suggesting that "the higher the ODD, the worse the impairment".
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Effect of refractive status on retinal nerve fiber layer thickness in Chinese Population. Graefes Arch Clin Exp Ophthalmol 2023; 261:201-211. [PMID: 35913557 DOI: 10.1007/s00417-022-05753-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To evaluate the relationship between retinal nerve fiber layer (RNFL) thickness and other related parameters measured by spectral-domain optical coherence tomography and the refractive error of eyes. METHODS A total of 5394 subjects were enrolled in this population-based cohort study, who were divided into three groups by refractive state after they underwent a standardized ophthalmic examination: emmetropia (the absolute value should range from 0 to 0.5 D), low-moderate myopia (the absolute value of myopic error should range from 0.5 to 6 D), and high myopia (the absolute value of myopic error should be over than 6 D). R 3.6.1 software was adopted for statistical analysis. RESULTS Two thousand five hundred fifty-two subjects (4548 eyes) were collected in this study, with an average age of 53.14 ± 10.64 years. There were significant differences among groups in average central corneal curvature, spherical equivalent, and axial length (P < 0.001). The measurements of average retinal nerve fiber layer (RNFL) were 113.95 ± 10.62 μm, 112.97 ± 11.59 μm, and 101.88 ± 15.67 μm, respectively, in the emmetropia, low-moderate, and high myopia groups (P < 0.001). Meanwhile, there was a decreasing trend of cup area, cup volume, disc area, and rim area in the high myopia group compared with the emmetropia group (P < 0.001). CONCLUSION The measurements of RNFL thickness vary greatly with refractive error, and this study indicated that it is of great significance for the accurate diagnosis of glaucoma to establish an individualized RNFL thickness database.
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Ahn YJ, Park YY, Shin SY. Peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children. Eye (Lond) 2022; 36:533-539. [PMID: 33731891 PMCID: PMC8873397 DOI: 10.1038/s41433-021-01461-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To analyse structural characteristics and perifoveal/peripapillary vasculature by OCT in children with peripapillary hyperreflective ovoid mass-like structures (PHOMS) and compare the results with those of normal subjects. METHODS Forty-five patients (84 eyes) under 18 years old with blurry disc margin were evaluated with spectral domain-OCT and swept course-OCT. Patients were divided into four groups, according to presence of PHOMS and then the size of the existing PHOMS. Eyes with visible optic disc drusen (ODD) were not included. Foveal avascular zone (FAZ) and vessel densities from macula and optic disc area were assessed and potential associations between vessel density and structural parameters, such as peripapillary retinal nerve fibre layer (pRNFL), and macular ganglion cell and inner plexiform layer (mGCIPL) thickness, were analysed. RESULTS Among 45 patients (eighty-four eyes), coexisting buried ODD were found only in eyes with PHOMS. The scleral canal diameter was significantly smaller in PHOMS positive eyes compared to control eyes. Vessel density measurements from the papillary, peripapillary and optic nerve head (ONH) regions in the large PHOMS group were significantly lower compared to the control group (papillary; P = 0.014, peripapillary; P = 0.001, ONH; P = 0.046). FAZ area and macular vessel densities showed no difference compared to normal eyes in all three PHOMS groups. pRNFL and mGCIPL thickness did not differ among four groups and correlations were also not significant. CONCLUSIONS Children with PHOMS have smaller scleral canal and can entail buried ODD. Vessel densities of optic disc area in large PHOMS eyes are significantly lower than in normal eyes.
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Affiliation(s)
- Ye Jin Ahn
- grid.411947.e0000 0004 0470 4224Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Yeon Park
- grid.411947.e0000 0004 0470 4224Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun Young Shin
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Visual field defects due to optic nerve drusen in Afro-Caribbean patients: A case series of 16 eyes. J Fr Ophtalmol 2021; 44:989-994. [PMID: 34147275 DOI: 10.1016/j.jfo.2020.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/19/2020] [Accepted: 10/05/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Optic Nerve Head Drusen (ONHD) are very rare among black patients but may cause more severe visual defects in these patients. The goal of our study was to describe the frequency of visual field defects secondary to OND in Afro-Caribbean patients and study the characteristics of their physical examination, color vision and contrast sensitivity. METHODS We carried out a prospective study at the Martinique university medical center on patients of African descent with ONHD diagnosed on fundus examination and B-scan ultrasonography. All patients received a complete neuro-ophthalmological examination. The primary study endpoint was the frequency of visual field defects. Secondary study endpoints were the results of ETDRS visual acuity, Pelli-Robson contrast sensitivity chart, and 15 hue color vision test. RESULTS Sixteen eyes of 10 patients from 11 to 68 years of age were included. Forteen eyes (87%) had exposed ONHD. Eleven eyes (69%) showed a visual field defect: 9 eyes (69%) had an enlarged blind spot, and 9 eyes (69%) had an arcuate scotoma. 3 eyes (19%) had loss of ETDRS visual acuity, and 12 eyes (75%) showed loss of Pelli-Robson contrast sensitivity. Five eyes (31%) had an abnormal color vision test. CONCLUSION This is one of the largest case series of ONHD in Black patients. The frequency of visual field defects was high but comparable to that of studies in other ethnic groups. Larger comparative studies are necessary to confirm these results.
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Yan Y, Zhou X, Chu Z, Stell L, Shariati MA, Wang RK, Liao YJ. Topographic Quadrant Analysis of Peripapillary Superficial Microvasculature in Optic Disc Drusen. Front Neurol 2021; 12:666359. [PMID: 34093412 PMCID: PMC8170317 DOI: 10.3389/fneur.2021.666359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Limited information is known about the topographic effect of optic disc drusen (ODD) on peripapillary retinal nerve fibers and microvasculature. Objective: This study aims to understand the structural and functional impact of ODD in different quadrants of the optic disc. Methods: We performed a retrospective case-control study of 22 ODD patients (34 eyes) and 26 controls (33 eyes) to compare optical coherence tomography (OCT) retinal nerve fiber layer (RNFL), OCT angiography (OCTA), and corresponding static perimetry mean deviation (MD) calculated using the modified Garway-Heath map in different quadrants of the optic disc. OCTA was analyzed using custom MATLAB script to measure six parameters in a peripapillary annulus with large vessel removal: vessel area density (VAD), vessel skeleton density (VSD), vessel perimeter index (VPI), vessel complexity index (VCI), flux, and vessel diameter index (VDI). Results: Quadrant analysis revealed that OCTA VAD and VCI were significantly decreased in superior, nasal, and inferior but not temporal quadrant. RNFL, VSD, and VPI were significantly impacted only in the superior and nasal quadrants. Corresponding visual field MDs in all ODD eyes were not different in the four quadrants, although eyes with MD equal or worse than -5 dB (32%) had worst visual field corresponding to the superior quadrant of the optic disc (inferior arcuate visual field). Structure-structure comparison of OCT and OCTA showed high correlation of RNFL with multiple OCTA measurements in the superior, nasal, and inferior quadrants but not temporal quadrant. Structure-function analysis revealed significant correlation of VAD and VCI and visual field MD in every quadrant, but RNFL was only significantly correlated in the superior and inferior quadrants. Conclusions: Peripapillary VAD and VCI are decreased in more quadrants than RNFL, supporting the clinical utility of performing OCTA in addition to OCT. Consistent with the most common locations of ODD, five OCT/OCTA measurements (VAD, VCI, RNFL, VSD, VPI) are decreased in the superior and nasal quadrants. OCT/OCTA measurements were significantly impacted in contrast to the relatively mild effect on corresponding visual field MD, consistent with the idea that a decrease in objective structural and vascular measurements occurs without parallel change in subjective visual function in ODD.
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Affiliation(s)
- Yan Yan
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, United States.,Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Zhou
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Laurel Stell
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, United States
| | - Mohammad Ali Shariati
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, United States
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, WA, United States.,Department of Ophthalmology, University of Washington, Seattle, WA, United States
| | - Yaping Joyce Liao
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, United States.,Department of Neurology, Stanford University School of Medicine, Stanford, CA, United States
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Kinetic and static perimetry after 16 years and additional OCT-A analysis in eyes with long-lasting optic disc drusen. PLoS One 2021; 16:e0247399. [PMID: 33630902 PMCID: PMC7906410 DOI: 10.1371/journal.pone.0247399] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/06/2021] [Indexed: 01/30/2023] Open
Abstract
The aim of the study is to evaluate the progression of visual field (VF) defects over 16 years of observation and to assess abnormalities in vessels and retinal nerve fibre layer (RNFL) thickness in patients with optic disc drusen (ODD). Both static automated perimetry (SAP) and semi-automated kinetic perimetry (SKP) were performed in 16 eyes of 8 patients (mean age 54 years) with ODD among 26 eyes of 13 patients examined 16 years before. The area of I2e, I4e, III4e, and V4e isopters was measured in deg2. The MD and PSD parameters were estimated using SAP. Optical coherence tomography angiography (OCT-A) was additionally performed in 16 ODD eyes and 16 eyes of 8 healthy subjects to estimate the RNFL thickness and vessel density of the optic nerve disc and the macula. The differences in all isopter areas of SKP and SAP parameters after 16 years were not significant. The analysis of OCT-A showed a significant reduction of the vessel density and RNFL of the peripapillary area in each segment in patients with ODD, compared with the control group. The highest reduction of RNFL was observed in the superior segment of the optic disc area (92.56μm vs 126.63μm) also the macular thickness was decreased in ODD patients, compared with the control group. In the macula, there was a significant vascular defect in the whole superficial layer and in the parafoveal deep layer. A strong significant correlation of the parafoveal deep plexus with MD and PSD parameters was detected. In conclusion, VF loss due to ODD after 16 years of the follow-up was not significant both in SKP and SAP. ODD caused a reduced vessel density and RNFL, as well as macular thickness in OCT-A. SAP parameters were influenced by parafoveal deep plexus.
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Türker IÇ, Doğan CU, Uzun SÜ, Güven D. Peripapillary vessel density in pediatric cases with buried optic disk drusen. Int Ophthalmol 2021; 41:1337-1345. [PMID: 33459960 DOI: 10.1007/s10792-021-01700-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/08/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the retinal nerve fiber layer (RNFL) and peripapillary vascular density (VD) changes in the pediatric group with optic disk drusen (ODD). METHODS Sixty eyes of 30 patients with buried ODD referred by the pediatric or neurology physicians to ophthalmology clinic with a preliminary diagnosis of papillary edema were included in this retrospective study. Sixty eyes of 30 healthy children were included as the control group. Thickness of RNFL (micrometer) and VD percentages (%) of the superior, inferior, nasal, and temporal quadrants of the peripapillary region of all cases were evaluated with optical coherence tomography angiography (OCT-A) device. RESULTS The study and control groups were homogeneous in terms of age and gender. VD values were significantly lower in the study group for all four quadrants, when compared to controls (p < 0.001, p < 0.001, p = 0.003, and p < 0.001, for inferior, superior, nasal, and temporal quadrants, respectively. For RFNL thickness measurements, a significant difference between groups was only evident for the nasal quadrant, where the study group had significantly higher nasal RFNL thickness (p = 0.001). CONCLUSION This study detected decreases in peripapillary VD values in all quadrants and peripapillary RNFL thickening in nasal quadrant in pediatric cases with buried drusen compared to healthy controls. Further studies are necessary to reveal the effects of drusen pathogenesis on optic nerve head perfusion and to understand the underlying mechanisms of related complications.
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Affiliation(s)
- Ibrahim Çağrı Türker
- Department of Ophthalmology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street 34371, Şişli, Istanbul, Turkey.
| | - Ceylan Uslu Doğan
- Department of Ophthalmology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street 34371, Şişli, Istanbul, Turkey
| | - Saniye Üke Uzun
- Department of Ophthalmology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street 34371, Şişli, Istanbul, Turkey
| | - Dilek Güven
- Department of Ophthalmology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street 34371, Şişli, Istanbul, Turkey
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Yan Y, Zhou X, Chu Z, Stell L, Shariati MA, Wang RK, Liao YJ. Vision Loss in Optic Disc Drusen Correlates With Increased Macular Vessel Diameter and Flux and Reduced Peripapillary Vascular Density. Am J Ophthalmol 2020; 218:214-224. [PMID: 32360344 DOI: 10.1016/j.ajo.2020.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine the key optical coherence tomography (OCT) and OCT angiography (OCTA) parameters that correlate with visual field loss in optic disc drusen (ODD). DESIGN Retrospective cross-sectional study. METHODS Single academic center. Seventeen patients with ODD (29 eyes) and 35 age-matched controls (53 eyes). Static perimetry, OCT, and OCTA imaging of optic disc and macula. Static perimetry, OCT, and OCTA measurements. RESULTS We investigated the relationship between static perimetry and 14 OCT/OCTA measurements in patients with ODD vs age-matched controls and found 5 key measurements that most correlated with visual field loss included: peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC), peripapillary vessel area density (VAD), macular vessel diameter (VD), and flux. Hierarchical clustering of these 5 measurements vs all clinical characteristics revealed 3 distinct clusters. ODD and control eyes with no visual field loss (mean deviation [MD] > -2.0 dB) had high RNFL and GCC, and low macular VD and flux. ODD eyes with mild visual field loss (MD -2.0 to -5.0 dB) had high RNFL, GCC, and increased macular VD and flux. ODD eyes with moderate/severe visual field loss (MD < -5.0 dB) had decreased RNFL, GCC, peripapillary VAD, and increased macular VD and flux. CONCLUSIONS OCT and OCTA provided objective measurements that can help predict visual field loss in ODD. Our data suggest that increased macular flow may be an early biomarker of visual field loss in ODD, while decreased peripapillary vessel density and RNFL thickness are late biomarkers of visual field loss in ODD.
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Leal‐González M, Pessanha F, Azevedo González‐Oliva M, Pérez‐Fernández E, Gili P. Study of peripapillary vascular flow using optical coherence tomography angiography in optic nerve head drusen. Clin Exp Ophthalmol 2020; 48:775-782. [DOI: 10.1111/ceo.13783] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Filipa Pessanha
- Ophthalmology Unit, Hospital Universitario Fundación Alcorcón Madrid Spain
| | | | | | - Pablo Gili
- Ophthalmology Unit, Hospital Universitario Fundación Alcorcón Madrid Spain
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Allegrini D, Pagano L, Ferrara M, Borgia A, Sorrentino T, Montesano G, Angi M, Romano MR. Optic disc drusen: a systematic review : Up-to-date and future perspective. Int Ophthalmol 2020; 40:2119-2127. [PMID: 32383130 DOI: 10.1007/s10792-020-01365-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/01/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Optic disc drusen (ODD) are acellular deposits in the prelaminar optic nerve head. The most accredited theory is that they are secondary to abnormalities in axonal metabolism and degeneration, but the pathogenesis is not clear to date. CLINICAL MANIFESTATION Although ODD are often considered a benign condition, the great majority of patients with ODD show visual field defects and are at higher risk for developing anterior ischemic optic neuropathy. ODD are classified as superficial or buried, with the latter being often misdiagnosed as papilledema with optic nerve head swelling, leading to an unnecessary investigation for causes of increased intracranial pressure. AIM The recent technological improvements in OCT imaging which allowed an earlier and more certain diagnosis even of the smallest ODD, renovated the interest around this pathology. However, an updated systematic review is still missing. Therefore, the aim of this work is to provide a concise yet comprehensive overview of the current state of art, focusing on pathophysiology, clinical presentation, diagnostic methods, treatment modalities and potential future perspectives of this condition.
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Affiliation(s)
- Davide Allegrini
- Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy.,Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy
| | - Luca Pagano
- Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy. .,Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy. .,Department of Bioscience, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milano, Italy.
| | - Mariantonia Ferrara
- Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy
| | - Alfredo Borgia
- Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy.,Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy
| | - Tania Sorrentino
- Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy.,Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy
| | - Giovanni Montesano
- Eye Clinic, Department of Bioscience, University of Milan, 20142, Milan, Italy
| | - Martina Angi
- National Cancer Institute IRCCS Foundation, Via Venezian, 1, 20133, Milan, Italy
| | - Mario R Romano
- Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy.,Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy
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Skougaard M, Heegaard S, Malmqvist L, Hamann S. Prevalence and histopathological signatures of optic disc drusen based on microscopy of 1713 enucleated eyes. Acta Ophthalmol 2020; 98:195-200. [PMID: 31264343 DOI: 10.1111/aos.14180] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/07/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Optic disc drusen (ODD) are calcified optic nerve head deposits. Objectives of this study were to examine the prevalence of ODD in eyes removed by enucleation and to describe related histopathological signatures of ODD and surrounding tissues. METHODS The study was a retrospective observational case series study assessing and re-evaluating enucleated eyes in Denmark from 1980 to 2015 by microscopy. Individual ODD were described based on size, number and location (superficial and/or deep) within the optic nerve. Optic nerve heads with ODD were assessed for elevated discs, retinal nerve fibre layer (RNFL) thickness, oedematous axons and presence of localized peripapillary axonal distension (LPAD) equivalent to the peripapillary hyperreflective ovoid mass-like structures seen on optical coherence tomography. RESULTS Microscopy of 1713 eyes revealed ODD in 31 eyes equivalent to a prevalence of 1.8%. Optic disc drusen (ODD) were seen as circular shapes of different sizes and varying number. Elevated discs were present in 15 (54%) of the cases. Thickening of the superficial RNFL was present in eyes with large deeply located ODD. For more superficial ODD of approximately same size, the RNFL was thinner. Oedematous axons were present in three eyes. Localized peripapillary axonal distension (LPAD) was seen in five eyes. CONCLUSIONS Prevalence of ODD in this study of histopathological signatures was higher than the prevalence found in clinical studies. Our results suggest that large, deep ODD might cause crowding and herniation of axons in the optic nerve head leading to a thickened superficial nerve fibre layer, pseudopapilledema and LPAD.
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Affiliation(s)
- Marie Skougaard
- Department of Ophthalmology Rigshospitalet University of Copenhagen Glostrup Denmark
| | - Steffen Heegaard
- Department of Ophthalmology Rigshospitalet University of Copenhagen Glostrup Denmark
- Department of Pathology Rigshospitalet University of Copenhagen Glostrup Denmark
| | - Lasse Malmqvist
- Department of Ophthalmology Rigshospitalet University of Copenhagen Glostrup Denmark
| | - Steffen Hamann
- Department of Ophthalmology Rigshospitalet University of Copenhagen Glostrup Denmark
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Abstract
BACKGROUND Optic disc drusen (ODD) are seen in up to 2.4% of the general population, but the etiology and pathophysiology of the condition is still unknown. The purpose of this study was to determine the prevalence of ODD in a population-based child cohort and to determine if scleral canal diameter and fetal birth and pubertal parameters are associated with the presence of ODD. METHODS This observational, longitudinal population-based birth cohort study, with a nested case-control, included 1,406 children. Eye examinations were performed when the children were between 11 and 12 years of age. Assessment was performed of optical coherence tomography (OCT) scans from 1,304 children with gradable enhanced depth imaging scans of the optic disc. RESULTS ODD in one or both eyes were found in 13 (1.0%) of all children. All but one of the cases were found in children with scleral canal diameter in the lowest quartile (1,182-1,399 μm) in the nested case-control study. Children with ODD had a mean disc diameter of 1,339 μm (interquartile range, 30 μm), whereas it was 1,508 μm (interquartile range, 196 μm) in the 130 controls without ODD (P < 0.001). No differences in sex, birth weight, refractive error, and Tanner stages (of puberty) were found between children with and without ODD. CONCLUSIONS The prevalence of ODD was 1% in a large child cohort examined by OCT. ODD was found only in eyes with a narrow scleral canal, which is consistent with the hypothesis that ODD might arise as a consequence of retinal nerve fiber congestion in the scleral canal.
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Hamann S, Malmqvist L, Costello F. Optic disc drusen: understanding an old problem from a new perspective. Acta Ophthalmol 2018; 96:673-684. [PMID: 29659172 DOI: 10.1111/aos.13748] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/07/2018] [Indexed: 01/22/2023]
Abstract
Optic disc drusen (ODD) are acellular deposits located in the optic nerve head of up to 2.4% of the population. They may develop as by-products of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Although ODD are often considered as benign innocent bystanders, recognized as part of a routine ophthalmological examination, the vast majority of patients with ODD have visual field defects. Optic disc drusen (ODD)-associated complications with severe visual loss, most often due to anterior ischaemic optic neuropathy, are also known to occur. There are no treatments available to prevent or ameliorate the vision loss caused by ODD. In children, the ODD are usually uncalcified and buried within the optic nerve head tissue. In these cases, the condition can be difficult to diagnose, as it often resembles a papilloedema with optic nerve head swelling caused by raised intracranial pressure. During the teenage years, the ODD progressively become more calcified and probably also larger, which allow them to be visible on ophthalmoscopy. With the advent and proper utilization of high-resolution modalities of optical coherence tomography (OCT), it has now become possible to detect even the smallest and most deeply located ODD. This allows for ODD detection at a much earlier developmental stage than has previously been possible and enhances the possibilities of research in underlying mechanisms. A review of the literature on ODD was conducted using the PUBMED database. The review focuses on the current knowledge regarding pathogenesis, diagnostics, clinical disease-tracking methodologies, structure-function relationships and treatment strategies of ODD.
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Affiliation(s)
- Steffen Hamann
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
| | - Lasse Malmqvist
- Department of Ophthalmology; Rigshospitalet; University of Copenhagen; Glostrup Denmark
| | - Fiona Costello
- Department of Clinical Neurosciences; University of Calgary; Calgary Canada
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15
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Factors associated with visual field defects of optic disc drusen. PLoS One 2018; 13:e0196001. [PMID: 29708976 PMCID: PMC5927402 DOI: 10.1371/journal.pone.0196001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 04/04/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the prevalence and risk factors for visual field defect in patients with optic disc drusen (ODD). Methods We assessed the visual field status of patients with ODD whose diagnosis were confirmed by spectral-domain optical coherence tomography (SD-OCT). Visual field defects were classified as normal, enlarged blind spot, or other defects. ODD were classified into either type 1 (without hyperreflective border and heterogenic internal reflectance) or type 2 (with hyperreflective border and lower internal reflectance). The prevalence and risk factors for each visual field defect was analyzed using logistic regression analysis and classification and regression tree (CART) modeling. Results Of the 40 eyes with ODD, 33 (83%) eyes were categorized as type 1 and 7 (17%) eyes were categorized as type 2 ODD. Regarding the visual field defects, 19 (48%) eyes showed normal visual field, 11 (28%) eyes showed enlarged blind spot, and 9 (24%) eyes showed other defects. The latter was more frequent in type 2 ODD (P = 0.001). Logistic regression analysis revealed that the factor associated with other defects was the thinning of the average retinal nerve fiber layer (RNFL) (per 10 μm decrease, OR = 3.436, P = 0.004), and the factor associated with enlarged blind spot was the height of ODD (per 100 μm increase, OR = 3.956, P = 0.023). CART modeling revealed that the average RNFL thickness lesser than 85.5 μm, and then the ODD height larger than 348 μm were the best split-up factors for predicting the type of visual field defects. Conclusions In this study, one-quarter of ODD patients showed abnormal visual field defect other than enlarged blind spot. These other visual field defects appeared to be associated with the axonal loss in the eyes with type 2 ODD.
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17
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Relationship Between Optic Nerve Head Drusen Volume and Structural and Functional Optic Nerve Damage. J Glaucoma 2017; 26:1095-1100. [DOI: 10.1097/ijg.0000000000000783] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Volumetric Measurement of Optic Nerve Head Drusen Using Swept-Source Optical Coherence Tomography. J Glaucoma 2017; 26:798-804. [PMID: 28857944 DOI: 10.1097/ijg.0000000000000707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To describe new software tools for quantifying optic nerve head drusen volume using 3-dimensional (3D) swept-source optical coherence tomography (SS-OCT) volumetric scans. MATERIALS AND METHODS SS-OCT was used to acquire raster volume scans of 8 eyes of 4 patients with bilateral optic nerve head drusen. The scans were manually segmented by 3 graders to identify the drusen borders, and thereafter total drusen volumes were calculated. Linear regression was performed to study the relationships between drusen volume, retinal nerve fiber layer thickness, and Humphrey visual field mean deviation. RESULTS In the 8 study eyes, drusen volumes ranged between 0.24 to 1.05 mm. Visual field mean deviation decreased by ∼20 dB per cubic millimeter increase in drusen volume, and the coefficient of correlation of the linear regression was 0.92. In this small patient series, visual field defects were detected when drusen volume was larger than about 0.2 mm. CONCLUSIONS Software tools have been developed to quantify the size of OHND using SS-OCT volume scans.
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Optical Coherence Tomography to Differentiate Papilledema from Pseudopapilledema. Curr Neurol Neurosci Rep 2017; 17:74. [DOI: 10.1007/s11910-017-0790-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Traber GL, Weber KP, Sabah M, Keane PA, Plant GT. Enhanced Depth Imaging Optical Coherence Tomography of Optic Nerve Head Drusen: A Comparison of Cases with and without Visual Field Loss. Ophthalmology 2016; 124:66-73. [PMID: 27817914 DOI: 10.1016/j.ophtha.2016.09.022] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/02/2016] [Accepted: 09/16/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD OCT) has been recognized as the most sensitive tool to diagnose optic nerve head drusen (ONHD). The relationship between OCT characteristics and visual loss has not been well documented. This study compares EDI SD OCT-determined morphologic characteristics of drusen in eyes with or without visual field (VF) defects. DESIGN Descriptive study of patients attending the neuro-ophthalmology service of Moorfields Eye Hospital between January 2013 and October 2014. SUBJECTS Patients with diagnosed ONHD and EDI SD OCT imaging of the optic nerve head. METHODS Eyes with and without VF defects were compared with regard to retinal nerve fiber layer (RNFL) thickness, drusen morphology, size, extent, visibility on funduscopy, ultrasound, and fundus autofluorescence. MAIN OUTCOME MEASURES Difference in OCT characteristics of ONHD between patients with or without VF defects. RESULTS Of 38 patients, 69 eyes with ONHD were included. Thirty-three eyes had a normal VF with average mean deviation (MD) -0.96 (±1.2) dB and pattern standard deviation (PSD) 1.6 (±0.3) dB (group I), and 36 eyes had VF defects with MD -13.7 (±10.4) dB and PSD 7.2 (±3.6) dB (group II). Mean global RNFL thickness was 62 (±20.9) μm in the latter group and 99.0 (±12.9) μm in group I. In group I, the predominant drusen type was peripapillary drusen, of variable size. In group II, most eyes had confluent (P < 0.02) and large (>500 μm; P < 0.003) drusen, and drusen were more commonly visible on funduscopy (P = 0.001), ultrasound (P = 0.013), and autofluorescence (P = 0.002). Differences between the 2 groups reached statistical significance in a clustered analysis. RNFL thinning and autofluorescence showed relative sparing of the temporal sector. Sixty-four percent of patients with a VF defect in 1 eye also had a VF defect in their fellow eye. CONCLUSIONS Drusen size and drusen type as classified by OCT morphologic characteristics are significantly different in patients with or without VF defects. Confluent, large, and autofluorescent drusen were more commonly found in patients with VF defects. These findings may assist in clarifying how drusen give rise to visual loss, which is currently not known.
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Affiliation(s)
- Ghislaine L Traber
- Moorfields Eye Hospital, London, United Kingdom; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Konrad P Weber
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mazen Sabah
- Moorfields Eye Hospital, London, United Kingdom
| | - Pearse A Keane
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom
| | - Gordon T Plant
- Moorfields Eye Hospital, London, United Kingdom; The National Hospital for Neurology and Neurosurgery, London, United Kingdom; St Thomas' Hospital, London, United Kingdom
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22
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Chang MY, Pineles SL. Optic disk drusen in children. Surv Ophthalmol 2016; 61:745-758. [PMID: 27033945 PMCID: PMC5042815 DOI: 10.1016/j.survophthal.2016.03.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 01/26/2023]
Abstract
Optic disk drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disk drusen, particularly when buried, to simulate true optic disk edema. Misdiagnosing drusen as true disk edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disk drusen. Complications of optic disk drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, nonarteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor agents for choroidal neovascular membranes. In most cases, however, children with optic disk drusen can be managed by observation with serial examinations and visual field testing once true optic disk edema has been excluded.
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Affiliation(s)
- Melinda Y Chang
- Department of Ophthalmology, Stein Eye Institute, Los Angeles, California, USA; University of California, Stein Eye Institute, Los Angeles, California, USA
| | - Stacy L Pineles
- Department of Ophthalmology, Stein Eye Institute, Los Angeles, California, USA; University of California, Stein Eye Institute, Los Angeles, California, USA.
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Tuğcu B, Özdemir H. Imaging Methods in the Diagnosis of Optic Disc Drusen. Turk J Ophthalmol 2016; 46:232-236. [PMID: 28058166 PMCID: PMC5200836 DOI: 10.4274/tjo.66564] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 01/15/2016] [Indexed: 01/20/2023] Open
Abstract
Optic disc drusen (ODD) are benign congenital anomalies of the optic nerve characterized by calcified hyaline bodies. While superficial drusen can be diagnosed easily during fundus examination, detecting buried drusen requires the use of additional imaging methods such as B-scan ultrasonography (USG), fundus fluorescein angiography (FFA), computed tomography (CT) and fundus autofluorescence (FAF). ODD can be detected by USG with the presentation of highly reflective round structures. ODD appear as hyperautofluorescent areas on FAF and bright spots on CT scans. FFA can be helpful in differentiating ODD from true optic disc edema. Optic disc edema shows early hyperfluorescence due to diffuse leakage whereas ODD presents as well-defined hyperfluorescence in the late phase. In recent years, it has been reported that optical coherence tomography (OCT) examination has allowed more detailed evaluation of ODD and yielded useful findings for the differentiation of optic disc edema from ODD. In this review, the role of OCT in the diagnosis of ODD is discussed.
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Affiliation(s)
- Betül Tuğcu
- Bezmialem Vakıf University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Hakan Özdemir
- Bezmialem Vakıf University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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24
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Birnbaum FA, Johnson GM, Johnson LN, Jun B, Machan JT. Increased Prevalence of Optic Disc Drusen after Papilloedema from Idiopathic Intracranial Hypertension: On the Possible Formation of Optic Disc Drusen. Neuroophthalmology 2016; 40:171-180. [PMID: 27928403 DOI: 10.1080/01658107.2016.1198917] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022] Open
Abstract
This is a 25-year observational retrospective review of 372 consecutive participants with optic disc drusen or resolved papilloedema from idiopathic intracranial hypertension. The prevalence of optic disc drusen at 19% among eyes with resolved papilloedema was approximately 10 times higher and significantly increased (p < 0.001) as compared with the occurrence in the general population. Eyes with both resolved papilloedema and optic disc drusen had similar visual acuity and visual field outcome as compared with resolved papilloedema alone. Eyes with exposed drusen had significantly worse visual acuity and visual field outcome (p < 0.001) than buried drusen. The high prevalence of optic disc drusen after papilloedema has resolved suggests a non-coincidental relationship. Optic disc drusen formation can be a sequela of papilloedema.
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Affiliation(s)
- Faith A Birnbaum
- Neuro-Ophthalmology Unit, Department of Ophthalmology, Alpert Medical School of Brown University/Lifespan/Rhode Island Hospital , Providence, Rhode Island, USA
| | - Gabriella M Johnson
- Neuro-Ophthalmology Unit, Mason Eye Institute, University of Missouri , Columbia, Missouri, USA
| | - Lenworth N Johnson
- Neuro-Ophthalmology Unit, Department of Ophthalmology, Alpert Medical School of Brown University/Lifespan/Rhode Island Hospital , Providence, Rhode Island, USA
| | - Bokkwan Jun
- Neuro-Ophthalmology Unit, Mason Eye Institute, University of Missouri , Columbia, Missouri, USA
| | - Jason T Machan
- Lifespan Biostatistics Core, Departments of Orthopaedics and Surgery, Alpert Medical School of Brown University/Lifespan/Rhode Island Hospital , Providence, Rhode Island, USA
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Kang MT, Li SM, Li H, Li L, Li SY, Zhu BD, Guo YQ, Meng B, Sun YY, Ran A, Wang YP, Liu LR, Zhan SY, Thomas R, Wang N. Peripapillary retinal nerve fibre layer thickness and its association with refractive error in Chinese children: the Anyang Childhood Eye Study. Clin Exp Ophthalmol 2016; 44:701-709. [PMID: 27082378 DOI: 10.1111/ceo.12764] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 04/05/2016] [Accepted: 04/08/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
- Beijing Institute of Ophthalmology; Capital Medical University; Beijing China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
- Beijing Institute of Ophthalmology; Capital Medical University; Beijing China
| | - He Li
- Anyang Eye Hospital; Henan Province China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
| | - Si-Yuan Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
| | - Bi-Dan Zhu
- Department of Ophthalmology; Tongzhou Maternal and Child Health Hospital of Beijing; Beijing China
| | - Yi-Qin Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
| | - Bo Meng
- Department of Epidemiology and Health Statistics; Peking University School of Public Health; Beijing China
| | - Yun-Yun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
| | - Anran Ran
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
- Beijing Institute of Ophthalmology; Capital Medical University; Beijing China
| | | | - Luo-Ru Liu
- Anyang Eye Hospital; Henan Province China
| | - Si-Yan Zhan
- Department of Epidemiology and Health Statistics; Peking University School of Public Health; Beijing China
| | - Ravi Thomas
- Queensland Eye Institute; Brisbane Australia
- University of Queensland; Brisbane Queensland Australia
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab; Beijing China
- Beijing Institute of Ophthalmology; Capital Medical University; Beijing China
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Peripapillary Retinal Nerve Fiber Layer Thickness Corresponds to Drusen Location and Extent of Visual Field Defects in Superficial and Buried Optic Disc Drusen. J Neuroophthalmol 2016; 36:41-5. [DOI: 10.1097/wno.0000000000000325] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Almog Y, Nemet A, Nemet AY. Optic disc drusen demonstrate a hyperechogenic artifact in B mode ultrasound. J Clin Neurosci 2016; 23:111-119. [DOI: 10.1016/j.jocn.2015.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/14/2015] [Indexed: 11/27/2022]
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28
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Rebolleda G, Diez-Alvarez L, Casado A, Sánchez-Sánchez C, de Dompablo E, González-López JJ, Muñoz-Negrete FJ. OCT: New perspectives in neuro-ophthalmology. Saudi J Ophthalmol 2014; 29:9-25. [PMID: 25859135 DOI: 10.1016/j.sjopt.2014.09.016] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/09/2014] [Indexed: 01/03/2023] Open
Abstract
Optical coherence tomography (OCT) has become essential to evaluate axonal/neuronal integrity, to assess disease progression in the afferent visual pathway and to predict visual recovery after surgery in compressive optic neuropathies. Besides that OCT testing is considered a powerful biomarker of neurodegeneration and a promising outcome measure for neuroprotective trials in multiple sclerosis (MS). Currently, spectral-domain OCT (SD-OCT) technology allows quantification of retinal individual layers. The Ganglion Cell layer (GCL) investigation has become one of the most useful tools from a neuro-ophthalmic perspective. It has a high correlation with perimetry, is predictive of future progression and is a highly sensitive, specific of several neuro-ophthalmic pathologies. Moreover the superior correlation with clinical measures compared to peripapillary retinal nerve fiber layer (pRNFL) suggests that GCL analysis might be a better approach to examine MS neurodegeneration. In disorders with optic disk edema, such as ischemic optic neuropathy, papillitis and papilledema, reduction in RNFL thickness caused by axonal atrophy is difficult to distinguish from a swelling resolution. In this setting, and in buried optic nerve head drusen (ONHD), GCL analysis may provide more accurate information than RNFL analysis and it might be an early structural indicator of irreversible neuronal loss. Enhanced depth imaging OCT (EDI-OCT) provides in vivo detail of ONHD, allowing to evaluate and quantify the drusen dimensions. OCT is improving our knowledge in hereditary optic neuropathies. Furthermore, there is growing evidence about the role of OCT as an adjunctive biomarker of disorders such as Alzheimer and Parkinson's disease.
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Affiliation(s)
- Gema Rebolleda
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Laura Diez-Alvarez
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Alfonso Casado
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Carmen Sánchez-Sánchez
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Elisabet de Dompablo
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Julio J González-López
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
| | - Francisco J Muñoz-Negrete
- Hospital Universitario Ramón y Cajal. IRYCIS, Ophthalmology Service, University of Alcala, Madrid, Spain
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Measurement of retinal nerve fiber layer and macular ganglion cell-inner plexiform layer with spectral-domain optical coherence tomography in patients with optic nerve head drusen. Graefes Arch Clin Exp Ophthalmol 2014; 252:1653-60. [PMID: 25128962 DOI: 10.1007/s00417-014-2773-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 07/11/2014] [Accepted: 08/06/2014] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To evaluate the effect of optic nerve head drusen (ONHD) on the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) using Cirrus optical coherence tomography (OCT). METHODS Fifty-seven eyes of thirty patients with ONHD and thirty-eight eyes of twenty age-matched and sex-matched control subjects underwent circumpapillary and macular scanning using Cirrus OCT. The percentages of eyes with abnormal GCIPL and RNFL values according to the Cirrus normative data were analysed and compared. RESULTS Overall, eyes with ONHD showed abnormally reduced values for average and minimum GCIPL thicknesses in 35 % and 45 % of cases compared to 2 % for both values in control eyes (P < 0.001). Average RNFL thickness comparison between eyes with ONHD and normal eyes revealed abnormal thinning in 33 % vs. 0 %, respectively (p = 0.002). The percentage of abnormal thinning increased with higher grades of ONHD for all the parameters evaluated, so that in grade III drusen, values were abnormally reduced in 80 % of eyes in all three analyses. Regarding buried ONHD, 30 % and 4 % of eyes had an abnormally reduced minimum GCIPL and average RNFL thickness, respectively. Furthermore, 26 % of these eyes had abnormal GCIPL exams with a normal or increased RNFL thickness. CONCLUSIONS Both RNFL and GCIPL analysis reveal significant thinning in eyes with ONHD directly correlated with drusen severity. In buried ONHD, the abnormality rate was significantly higher with GCIPL compared to RNFL evaluation, suggesting that GCIPL analysis might be an early structural indicator of neuronal loss in the setting of thickened RNFL.
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