Acute Zonal Occult Outer Retinopathy in a Patient Suffering from Epilepsy: Five-Year Follow-Up.

We report an unprecedented case of a young patient with epilepsy coexisting with acute zonal occult outer retinopathy (AZOOR), a rare white dot syndrome of unknown etiology, associated with damage to the large zones of the outer retina. Recently, it has been established that epileptic episodes contribute to an inflammatory response both in the brain and the retina. A 13-year-old male patient with epilepsy was referred by a neurologist for an ophthalmologic consultation due to a sudden deterioration of visual acuity in the left eye. The examination, with a key role of multimodal imaging including color fundus photography, fluorescein angiography, indocyanine green angiography (ICGA), fundus autofluorescence (FAF), swept-source optical coherence tomography (SS-OCT) with visual field assessment, and electroretinography indicated AZOOR as the underlying entity. Findings at the first admission included enlargement of the blind spot in visual field examination along a typical trizonal pattern, which was revealed by FAF, ICGA, and SS-OCT in the left eye. The right eye exhibited no abnormalities. Seminal follow-up revealed no changes in best corrected visual acuity, and multimodal imaging findings remain unaltered. Thus, no medical intervention is required. Our case and recent laboratory findings suggest a causative link between epilepsy and retinal disorders, although this issue requires further research.

The assessment of multifocal ERG responses in school-age children with history of prematurity.

PURPOSE: The authors examined macular function in preterm-born children, using multifocal ERG (mfERG). Possible alterations in P1 amplitudes, P1 amplitudes density and P1 implicit time between school-age children with history of prematurity and their peers were researched. The correlations between parameters of mfERG responses and birth weight, gestational age, macular volume and central macular thickness were verified. METHODS: A group of 18 preterm-born school-age children were analyzed (mean age 10.18 ± 1.21 years). The study group was compared to the group of 15 peers born appropriate for gestational age (mean age 10.8 ± 1.52 years). The mfERG was evaluated in all children. RESULTS: There were statistically significant differences for P1 amplitudes from ring 1 (p = 0.0001) and P1 amplitudes density from ring 1 (p = 0.0001). Calculating the correlation coefficients, we receive significant results for P1 amplitudes from ring 1 versus gestational age (r = 0.54; p = 0.026), birth weight (r = 0.54; p = 0.026) and central macular thickness (r = -0.62; p = 0.008), and for P1 amplitudes density from ring 1 versus central macular thickness (r = -0.51; p = 0.034). CONCLUSIONS: The study suggests that P1 amplitudes and P1 amplitudes density vary in preterm-born children in comparison with their peers born appropriate for gestational age, which might suggest discreet macular dysfunction. The correlation between low birth weight, early gestational age, central macular thickness and mFERG components from ring 1 might evidence that decreased bipolar cells density caused by premature birth is the result of altered development of central retina reflecting in structural anomalies of the fovea.

The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia.

BACKGROUND: A significant increase in myopia among children and teenagers can be observed all over the world. Yet at the same time, there is still an insignificant number of studies concerning this health problem. The aim of this study was to assess the level of trait anxiety among myopic group of teenagers in comparison to teenagers with emmetropia, and to confirm whether the level of trait anxiety relates to age and gender. METHODS: Two hundred thirty-nine students aged 13-17 years were included in the study. The study group comprised 114 persons with myopia (81 girls and 33 boys), while the control group comprised 125 persons without refractive error (79 girls and 46 boys). Volunteers completed a set of questionnaires including: personal data, State-Trait Anxiety Inventory for Children (STAIC) (13-14 year-olds), or State-Trait Anxiety Inventory (STAI) (15-17 year-olds). The trait anxiety subscales were thus analyzed. RESULTS: Among younger adolescents (13-14 years of age) with myopia there was a significantly higher incidence of pathological intensification of anxiety as a constant trait. After taking into account the distribution of gender, there was a higher level of trait anxiety in the group of boys with myopia than in the control group aged 13-17 years and 13-14 years. There was also a higher level of trait anxiety detected in males than in females. CONCLUSIONS: Myopia may affect the level of trait anxiety among 13-14-year-olds. In both age groups of girls, a higher percentage of patients with high level of anxiety was discovered (≥7 sten), as compared to their peers without vision defects. Our results can contribute to a more accurate analysis of young teenagers' psychological problems, especially among boys diagnosed with myopia.

Traumatic hyphema in children and adolescents ­ aetiology and treatment.

Purpose: Retrospective analysis of patients with traumatic hyphema, including type of injury, treatment and visual outcome. Material and methods: We analysed a cohort of patients after blunt trauma, who were examined and treated between 2011­ ­2015. In each case, the baseline and ultimate visual acuity was determined, followed by slit lamp examination, intraocular pressure measurement, indirect binocular ophthalmoscopy of the fundus, ultrasound scan and OCT Visante. The type of treatment as well as duration of inpatient treatment and late complications were assessed for each case. Results: 45 patients (45 eyes) with traumatic hyphema due to blunt ocular trauma were enrolled. 42 of them were boys (93.3%), and 3 were girls (6.7%). The age range was 2.5­17.5 years (mean age of 11.92 ± 3.75 years). Upon admission, 10 (22.2%) children had full visual acuity (1.0). The most common injuries concomitant with hyphema included iridodialysis, corneal oedema, mydriasis and corneal erosion. Secondary hemorrhage occurred three days following injury in only one (2.2%) patient. The mean duration of inpatient admission was 4.3 days (ranged from 2 to 8 days). At the last follow-up visit, 36 (80%) patients had a full visual acuity of 1.0. Conclusions: Visual outcomes improve with earlier treatment commencement. Conservative management was sufficient to resolve traumatic hyphema in reported cases

Central nervous system tumour diagnosis in pediatric population ­ the role of an ophthalmologist and the utility of visual evoked potentials.

Objective: To determine possible alterations of P100 and P1 amplitudes and latencies in school-aged children with a history of a central nervous system tumour. Material and methods: The pattern visual evoked potential and flash visual evoked potential testing was performed in 42 school- -aged children: 15 patients with a history of the central nervous system tumour (mean age of 13.44 ± 2.41 years and 13.75 ± 2.29 years, respectively) and 27 healthy subjects as a control group (mean age 11.84 ± 1.44 years, and 14.78 ± 4.26 years, respectively). Results: P100 amplitudes of pattern visual evoked potentials were statistically decreased in the study group as compared to the control group. The only statistically signifcant difference between the study group and the controls was latencies recorded from O1 in 15-minute stimuli. P2 amplitudes of flash visual evoked potentials were decreased and latencies were increased in the study group, however, the differences were not statistically significant. Conclusions: Visual evoked potential alterations can be a sign of functional disturbances of the visual system in patients with any central nervous system tumour. Therefore, a diagnostic process of a central nervous system tumour should include a thorough ocular exam, even in patients with normal visual acuity.

Evaluation of macular structure and thickness using spectral optical coherence tomography SOCT Spectralis in children after prior laser photocoagulation performed due to the retinopathy of prematurity. / Ocena struktury i grubosci siatkówki w okolicy plamkowej za pomoca spektralnej optycznej koherentnej tomografii SOCT Spectralis u dzieci po przebytej laserokoagulacji siatkówki z powodu retinopatii wczesniaków.

Objectives: To evaluate morphobiometric properties of the macula (its structure and thickness) in children with a known history of retinopathy of prematurity using optical coherence tomography (SLO/OCT Spectralis). Material and methods: 16 subjects (group B1) (mean age 9.2 years) with a history of stage 3 retinopathy of prematurity treated with retinal laser photocoagulation and 18 subjects (group B2) with a history of spontaneously regressing retinopathy of prematurity (mean age 10.2 years) were studied prospectively. The control group consisted of 21 healthy subjects (group K) (mean age 10.9 years). Each participant underwent a thorough ocular examination and had an optical coherence tomography performed. The U Mann-Whitney and Spearman's rank correlation tests were used for statistical analyses. Results: The minimum central foveal thickness and total macular volume were significantly higher in both study groups (B1 and B2) as compared to the control group (K). The subfoveal choroidal thickness was reduced in both study groups (B1 and B2), as compared to the control group (K). Conclusions: The altered macular structure in eyes with the history of retinopathy of prematurity is related to the presence of all retinal layers within the fovea. However, these changes do not significantly affect visual acuity.

The opinion of the Expert Group of the Polish Society of Ophthalmology on using nepafenac in the prevention of postoperative macular edema after cataract surgery in diabetic patients.

Nepafenac is an innovative non-steroidal anti-inflammatory drug used in ophthalmology for the prevention of macular edema after cataract surgery. Along with its anti-inflammatory effect, nepafenac has some unique properties which distinguish it from other non-steroidal anti-inflammatory drugs. It is a prodrug activated to amfenac after it penetrates through the corneal layers to the aqueous humour and the ciliary body. Having electrically neutral molecules of lipophilic properties, nepafenac does not accumulate in the cornea and does not cause its degeneration. Additionally, it quickly achieves higher concentrations in the aqueous humour as compared to other non-steroidal anti-inflammatory drugs. Nepafenac shows high selectivity and activity against COX-2 isoform, the key enzyme implicated in inducing inflammation, which is the main cause of macular edema. Furthermore, nepafenac has the unique scleral and suprachoroidal distribution pathways. Finally, its effect on the intraocular pressure is none to negligible. Nepafenac treatment should be initiated prior to cataract surgery and continued long enough to reduce the risk of late-onset macular edema. The Expert Group of the Polish Society of Ophthalmology consider using nepafenac in the prevention of post­operative macular edema in diabetic patients undergoing cataract surgery as expedient and reasonable. The proposed optimum pre- and postoperative treatment regimen can be modified for individualised therapy.

Disturbances of modulating molecules (FOXP3, CTLA-4/CD28/B7, and CD40/CD40L) mRNA expressions in the orbital tissue from patients with severe graves' ophthalmopathy.

Purpose. To evaluate the relationship between the expression of orbital tissue mRNA for FOXP3, CTLA-4/CD28/CD80/CD86, and CD40/CD40 and the severity of Graves' orbitopathy (GO). Material and Methods. Orbital tissue was obtained from 26 patients with GO, with mild (n = 6) or severe GO (n = 20), and 7 healthy controls. The expression of mRNA of FOXP3, CTLA-4/CD28/CD80/CD86, CD40/CD40L was measured by RT-PCR. TCR and CD3 were evaluated by immunohistochemistry. Results. Higher mRNA for FoxP3 (relative expression: 1.4) and CD40 (1.27) and lower expression of CTLA-4 (0.61) were found in the GO tissues versus controls. In severe GO as compared to mild GO higher mRNA expression for FoxP3 (1.35) and CD40 (1.4) and lower expression for CTLA-4 (0.78), CD28 (0.62), and CD40L (0.56) were found. A positive correlation was found between FOXP3 mRNA and CD3 infiltration (R = 0.796, P = 0.0000001). Conclusions. The enhanced FOXP3 mRNA expression in GO samples may suggest the dysfunction of FOXP3 cells in the severe GO. The diminished mRNA expression of CTLA-4 in severe GO may indicate inadequate T regulatory function. The enhanced mRNA expression of CD40 in severe GO and negative correlation to CRP mRNA may suggest their role in the active and inactive GO.

An Influence of Birth Weight, Gestational Age, and Apgar Score on Pattern Visual Evoked Potentials in Children with History of Prematurity.

PURPOSE: The objective of our study was to examine a possible influence of gestational age, birth weight, and Apgar score on amplitudes and latencies of P100 wave in preterm born school-age children. MATERIALS AND METHODS: We examined the following group of school-age children: 28 with history of prematurity (mean age 10.56 ± 1.66 years) and 25 born at term (mean age 11.2 ± 1.94 years). The monocular PVEP was performed in all children. RESULTS: The P100 wave amplitudes and latencies significantly differ between preterm born school-age children and those born at term. There was an essential positive linear correlation of the P100 wave amplitudes with birth weight, gestational age, and Apgar score. There were the negative linear correlations of P100 latencies in 15-minute stimulation from O1 and Oz electrode with Apgar score and O1 and O2 electrode with gestational age. CONCLUSIONS: PVEP responses vary in preterm born children in comparison to term. Low birth weight, early gestational age, and poor baseline output seem to be the predicting factors for the developmental rate of a brain function in children with history of prematurity. Further investigations are necessary to determine perinatal factors that can affect the modified visual system function in preterm born children.

The smallest de novo deletion of 20q11.21-q11.23 in a girl with feeding problems, retinal dysplasia, and skeletal abnormalities.

We report on a de novo interstitial deletion of 20q11.21-q11.23 in a 2-year-old girl with a set of dysmorphic features, cleft palate, heart defect, severe feeding problems, failure to thrive, developmental delay, preaxial polydactyly (right thumb), and retinal dysplasia. Interstitial microdeletions of the long arm of chromosome 20 are rare. Exclusively rare are proximal microdeletions involving 20q11-q12 region. Our patient is the fourth described so far and has the smallest deleted region 20q11.21-q11.23 of 5.7 Mb. The defined clinical phenotype of our patient is very similar to previously published cases and confirms the existence of retinal dysplasia and skeletal abnormalities as a part of phenotypic spectrum for deletion 20q11-q12. Description of four similar patients, including two almost identical, suggests a new distinct, phenotypicaly recognizable microdeletion syndrome associated with the loss of 20q11-q12 region.

Immune recovery uveitis: pathogenesis, clinical symptoms, and treatment.

IRU is the most common form of immune reconstitution inflammatory syndrome in HIV-infected patients with cytomegalovirus retinitis who are receiving highly active antiretroviral therapy (HAART). Among patients with CMV in the HAART era, immune recovery may be associated with a greater number of inflammatory complications, including macular edema and epiretinal membrane formation. Given the range of ocular manifestations of HIV, routine ocular examinations and screening for visual loss are recommended in patients with CD4 counts <50 cells/µL. With the increasing longevity of these patients due to the use of HAART, treatment of IRU may become an issue in the future. The aim of this paper is to review the current literature concerning immune recovery uveitis. The definition, epidemiology, pathophysiology, clinical findings, complications, diagnosis, and treatment are presented.

[Visual function assessment in children after surgical management of congenital eyelid ptosis using the silicone rod]. / Ocena funkcji wzrokowych u dzieci po operacji wrodzonego opadniecia powieki górnej z zastosowaniem ekspandera silikonowego.

PURPOSE: To analyse the early and late postoperative visual function in children undergoing surgery for congenital eyelid ptosis with the use of silicone rod. MATERIAL AND METHODS: Congenital eyelid ptosis was diagnosed in 14 children aged 3-18 years. Analyzing the patients we focused on visual function parameters in early and late postoperative period. The follow up period ranged from 6 months to 1 year after the surgery. RESULTS: The visual outcome analysis in patients with congenital eyelid ptosis shows good functional and cosmetic results. The visual function improved gradually depending on patient age and severity of ptosis. CONCLUSIONS: Functional and aesthetic outcomes of the procedure performed using the silicone rod were good. The technique contributed to the shortened duration of postoperative visual rehabilitation period.

Evaluation of corneal endothelium in children and adolescents with type 1 diabetes mellitus.

PURPOSE: To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. MATERIALS AND METHODS: The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. RESULTS: The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm(2) and was significantly lower than in control group (2970.75 ± 270.1 cells/mm(2)). The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. CONCLUSIONS: ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT.

Plasma levels of IL-17, VEGF, and adrenomedullin and S-cone dysfunction of the retina in children and adolescents without signs of retinopathy and with varied duration of diabetes.

The study objective was to assess chosen biochemical parameters of blood and bioelectric function of the retina in patients with T1DM. The study group consisted of 41 patients with T1DM with no signs of diabetic retinopathy. The control group included 21 pediatric patients. We performed (1) S-cone ERG testing with retina response stimulation in both eyes at the luminance of 0.1, 0.2, and 0.5 (cd × s/m(2)) with the 440 nm blue flash and light application of the amber background (300 ph cd/m(2), 495 nm wavelength), (2) anthropometric measurements, (3) biochemical investigations: IL-17, VEGF, and ADM by the ELISA method. A comparison of the ERG results with biochemical investigations indicates a likely correlation between the worsening of retinal bioelectric function and VEGF levels growing with diabetes duration. We showed a negative correlation between ADM and HbA1c and described possible causes of ADM reduction observed in subgroup I. We demonstrated the presence of bioelectric retinal dysfunction already before the diagnosis of diabetic retinopathy, which provides new possibilities in the diagnosis of preclinical chronic complications of diabetes. The changes observed in the levels of IL-17, ADM, and VEGF suggest their involvement in the diabetic pathogenesis of eye diseases.

[Evaluation of anterior segment lesions in children and adolescents with ocular trauma using Visante OCT]. / Ocena zmian w przednim odcinku oka powstalych w nastepstwie urazów narzadu wzroku u dzieci i mlodziezy za pomoca OCT Visante.

AIM: To evaluate the anterior eye segment in children and adolescents after unilateral ocular trauma, using optical coherence tomography Visante OCT. MATERIAL AND METHODS: 19 patients (17 boys and 2 girls), hospitalized in Department of Pediatric Ophthalmology due to ocular trauma, were examined. Mean age was 12.6 years (6-17 years). 12 patients had blunt ocular trauma, and 7 patients had a penetrating injury. RESULTS: Hyphaema impeded the view in 5 eyes, so Visante OCT was helpful for the right treatment. The anterior chamber shallowing was diagnosed in 9 cases, and anterior chamber deepening in 5 cases. Lens pathology (subluxation, cataract) was recognized in 4 patients. OCT was useful in diagnosis of corneal wound (1 case) and in foreign body removal (1 case). CONCLUSIONS: Visante OCT provides easy visualization and high-resolution documentation. Its ability to image the anterior segment structures despite corneal opacification seems particularly important. This technique can be very useful in children and adolescents with ocular trauma.

[Surgical management of congenital eyelid ptosis with silicone rod--outcome analysis]. / Ocena wyników leczenia operacyjnego wrodzonego opadniecia powieki górnej z zastosowaniem ekspandera silikonowego.

PURPOSE: To analyze the outcomes of surgical management of congenital eyelid ptosis with the use of silicone rod. MATERIAL AND METHODS: Congenital eyelid ptosis was diagnosed in 12 children aged 2-18 years: 6 cases with unilateral, and 6 with bilateral ptosis. Analyzing the patients we focused on the function of levator muscle before and after the surgery in particular. Ptosis repair was performed with the use of silicone rod in all children. RESULTS: Functional and cosmetic outcomes of the procedure with the silicone rod were good.

[Assessment of macular and optic disc morphology in children with unilateral hypermmetropic amblyopia]. / Ocena morfologii siatkówki w plamce oraz tarczy nerwu wzrokowego u dzieci z jednoocznym niedowidzeniem nadwzrocznym.

PURPOSE: To investigate macular thickness and retinal nerve fiber layer thickness of the optic disc using high resolution spectral optical coherence tomography. MATERIAL AND METHODS: A study group consisted of 54 eyes of children aged from 5 to 13 years with unilateral hypermmetropic amblyopia. 25 children aged from 6 to 14 years with emmetropia or mild hyperopia (SE less than +1.0 D) were recruited as a reference group. All patients underwent a comprehensive ocular examination, including Scanning Laser Ophthalmoscope/Optical Coherence Tomography scans of the macula and the optic disc. The total macular volume, minimal central foveal thickness, parafoveal and perifoveal retinal thickness, global retinal nerve fiber layer thickness and in 4 quadrants were assessed using Statistica 10.0. RESULTS: The total macular volume was significantly higher in amblyopic as compared to non-amblyopic eyes--8.9 (8.09-9.27) in the study group, 8.3 (7.17-9.32) in the reference group respectively. However, the retinal nerve fiber layer was significantly thinner in amblyopic eyes. CONCLUSIONS: Amblyopia does not affect retinal thickness symmetry between the right and left eye. The analysis of Scanning Laser Ophthalmoscope/Optical Coherence Tomography morphometric parameters in amblyopic eyes is useful only when compared with the age-matched reference group. hypermmetropic amblyopia, macular retinal thickness, retinal nerve fiber layer thickness, spectral optical coherence tomography.

[Macular morphology and peripapillary retinal nerve fiber layer thickness in children with regressed retinopathy of prematurity]. / Morfologia siatkówki w plamce i grubosc warstwy wlókien nerwowych tarczy nerwu wzrokowego u dzieci z przebyta retinopatia wczesniaków.

PURPOSE: morphobiometric evaluation of macula and peripapillary retinal nerve fiber layer thickness with the use of high-resolution optical coherence tomography in children with a history of regressed retinopathy or prematurity. MATERIALS AND METHODS: 18 patients at the age of 8 to 14 years with a history of spontaneously regressed retinopathy of prematurity were studied prospectively. For statistical purposes a control group of 21 matched subjects at the age of 8 to 15 years was used. Ophthalmic examination and optical coherence tomography were performed in each patient. Peripapillary nerve fibre layer thickness, foveal and parafoveal thickness ratio, total macular volume and subfoveal choroidal thickness were measured in both groups. RESULTS: in the optical coherence tomography, the foveal thickness in children with retinopathy of prematurity was significantly higher [269.5 µm (232-321)] compared to the controls [224.5 µm (207-267)]. The macular volume in the study group was also higher (8.68 mm³). The subfoveal choroidal thickness was reduced in study group [321 µm (112-365)] compared to the control group [337 µm (294-358)]. There was no statistical significant difference in total peripapillary nerve fibre layer thickness between the two groups. CONCLUSION: The morphobiometric macular changes in eyes with a history of regressed retinopathy of prematurity are possibly related to the developmental abnormalities, which retinopathy of prematurity is due to the presence of the abnormal foveal structure across all retinal layers.

[Assessment of retinal ganglion cells thickness in high myopia]. / Ocena grubosci komórek zwojowych siatkówki w przebiegu wysokiej krótkowzrocznosci.

PURPOSE: Studies on glaucoma markers have shown that assessment of thickness macular ganglion cell complex plays an important role in diagnosis of early stage open-angle glaucoma. There are no available data on thickness in ganglion cell complex in high myopic patients. We investigate thickness of macular ganglion cell complex in children with high myopia. MATERIAL AND METHODS: 38 children (aged from 9 to 19 years), with high myopia (over -6.00 D) underwent full ophthalmological examination, including SD-OCT of the macula and optic disc. The reference group consisted of 38 emmetropic or slightly hyperopic children aged from 8 to 18 years old. RESULTS: Superior and interior ganglion cell complex (GCC) thickness were significantly lower in high myopic group compared to reference group: p < 0.01, respectively for GCC Sup. median was 90 microm (range 67-108.5) and 95 microm (range 80-105.5); for GCC Inf. median was 91 microm (range: 67-109.5) and 98 microm (range 85-109). Positive correlation between GCC and Total RNFL was found. CONCLUSIONS: In children with high myopia thinning of macular ganglion cell complex and retinal nerve fiber layer of the optic disc was found. These changes may be responsible for higher suspectibility of developing open-angle glaucoma in high myopic eyes. macular ganglion cell complex, high myopia, spectral optical coherence tomography.

[Optic nerve head drusen in children--visual function and OCT outcomes]. / Druzy tarczy nerwu wzrokowego u dzieci- -funkcja widzenia a obraz OCT.

PURPOSE: To evaluate the effect of optic nerve head drusen on retinal nerve fiber layer (RNFL) thickness in children, with the use of optical coherence tomography (OCT). MATERIAL AND METHODS: 21 patients (mean age 13.9 years) with optic nerve head drusen were studied prospectively. For statistic comparison a group of 15 control subjects (mean age 14.1 years) participated. Ophthalmologic examination, automated visual field testing and optical coherence tomography were performed in each patient. For statistical analysis we used Shapiro-Wilk and U Mann-Whitney tests. RESULTS: In the OCT measurements the nasal RNFL was significantly thinner as compared to the reference group. Neither statistically significant thinning of global RNFL between groups nor relation between subjects age and RNFL thickness was found. CONCLUSIONS: Optic nerve head drusen can lead to visual function defects, therefore early and correct diagnosis is mandatory. Optical coherence tomography is a usefull diagnostic tool used to determine the cause of disc elevation, which is especially important in childhood, when drusen can cause disc to appear papilledema-like. Overall OCT appears to be a non-invasive, sensitive and early-indicating method of RNFL thinning.