RESUMEN
PURPOSE: To evaluate the ophthalmoscopic manifestations of patients with visible and hidden optic disc drusen (ODD). METHOD: We studied 55 patients (100 eyes) with ODD that were confirmed using B-scan ultrasonography and a control group of 60 patients (100 eyes) for differential diagnosis. We analysed the optic nerve features with stereoscopic photography and compared the characteristics between visible and hidden ODD and between hidden ODD and papilloedema. RESULTS: The patients with ODD presented the following ophthalmoscopic features: visible drusen (52%), blurred edges (84%), raised optic disc (74%), absence of optic disc cupping (69%), absence of venous pulse (54%), abnormal vascular branching (81%), presence of cilioretinal vessels (42%), peripapillary atrophy (56%) and haemorrhages (2%). Comparison of the qualitative characteristics of the papillae of the eyes with visible and hidden ODD showed statistically significant differences in all parameters studied, except for morphological alterations (p = 0.851) and haemorrhage (p = 0.954). Comparison of hidden ODD with papilloedema showed statistically significant differences in blurred edges, disc elevation, absence of optic disc cupping, altered colour, anomalous vascular branching and optic disc haemorrhages (p < 0.005). CONCLUSIONS: Ophthalmologic features associated with ODD can help us to diagnose their presence and avoid confusing them with papilloedema.
Asunto(s)
Oftalmoscopía , Drusas del Disco Óptico/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Disco Óptico/diagnóstico por imagen , Papiledema/diagnóstico , Fotograbar , Ultrasonografía , Adulto JovenAsunto(s)
Ácidos Grasos Omega-3/administración & dosificación , Luteína/administración & dosificación , Mácula Lútea/patología , Degeneración Macular/tratamiento farmacológico , Degeneración Macular/patología , Drusas del Disco Óptico/patología , Xantófilas/administración & dosificación , Anciano de 80 o más Años , Suplementos Dietéticos , Femenino , Humanos , Mácula Lútea/efectos de los fármacos , Drusas del Disco Óptico/diagnóstico , Resultado del Tratamiento , ZeaxantinasRESUMEN
BACKGROUND: Although visual field defects are well-known complications of optic disc drusen, reduction in visual acuity with this condition is rare. METHOD/RESULTS: We report on a 68-year-old male with bilateral optic disc drusen who presented with monocular loss of vision in the right eye associated with an inferior altitudinal visual field defect and signs consistent with acute anterior ischaemic optic neuropathy, confirmed on fluorescein angiography. He also had a left inferior nasal step, but no evidence of glaucomatous cupping. The disc drusen were documented clinically and on B scan ultrasound and computed tomography. CONCLUSIONS: The diagnosis of acute anterior ischaemic optic neuropathy should be considered in patients with optic disc drusen who present with reduced visual acuity, particularly when the visual loss has been acute and non-progressive and is associated with altitudinal field loss and characteristic fluorescein angiography signs.