Atlas of Ophthalmology

Optic Nerve Head Drusen (Colour Photography Posterior Pole, OCT, Fundus Autofluorescence )

Nervio Óptico -> Neuropatías Ópticas -> Drusen del Nervio Óptico
Patient: 31 years of age, female, BVA 1.0 at OD, 1.0 at OS, IOP 15/16 mmHg. Ocular Medical History: General Medical History: empty. Purpose: to present autofluorescent drusen in optic nerve head with decreased retinal nerve thickness. Methods: Colour Photography Posterior Pole, OCT, Autofluorescence Imaging. Findings: Colour Photography Posterior Pole (OD): regular vessels, regular appearance of optic nerve head. Colour Photography Posterior Pole (OS): whitisch zones in temporal part of optic nerve head, irregular lumpy appearance, regular vessels, . OCT (OD): regular retinal nerve layer thickness. OCT (OS): thinned retinal nerve layer thicknes. Fundus Autofluorescence (OD): inherent autofluorescent properties of drusen in optic nerve head. Fundus Autofluorescence (OS): inherent autofluorescent properties of drusen in optic nerve head. Discussion: Optic nerve head drusen are calcific deposits buried or at the surface of the optic disc. Nentwich et al. reported (1) that drusen of the optic disc occur in 0.34 to 2.4 % of human individuals. Within histological sections drusen are found six times more often than on funduscopic examination. Diagnostic tools include fundus-autofluorescence, optical coherence tomography and ultrasound. Fundus Autofluorescence shows inherent autofluorescent properties of optic nerve head drusen. Drusen of the optic nerve head can lead to transient visual impairment, and to profound visual field defects in adulthood. The mechanism of drusen-related field loss is poorly understood. Tso (2) proposed that disc drusen are a consequence of abnormal axonal metabolism leading to the deposition of calcium crystals in mitochondria and disruption of axons with further accumulation of calcified cellular contents. Literature: (1) Nentwich MM, Maertz J, Rudolph G. Optic Disk Drusen: Historical and Up-To-Date Aspects. Klin Monbl Augenheilkd. 2016 Mar;232(3):257-65. (2) Tso MO. Pathology and pathogenesis of drusen of the optic nerve head. Ophthalmology. 1981;88:1066–1080.

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