Optic Disc Drusen

Optic disc drusen.

Optic disc drusen are hyaline or calcified deposits within the optic nerve head. They may be visible at the optic nerve head or buried. Nasal visual field defects and other glaucoma-like visual field defects may be present, though most visual field defects are asymptomatic.

There are many imaging modalities that help visualize optic nerve drusen, including B-scan ultrasonography (C), autofluorescence (D), and CT (E).

A. Fundus photograph of optic disc drusen, showing blurred disc margin with scalloped edge, refractile bodies on the disc surface and at the superior pole, mild pallor, and no obscuration of retinal blood vessels.

B. Visual field patterns confirmed the presence of a nasal step produced by drusen involving the right disc.

C. B-scan ultrasonogram, demonstrating focal, highly reflective (due to calcification) elevation within the optic disc (arrow), which persists when the gain is decreased

D. Preinjection fundus photograph demonstrating autofluorescence (arrow).

E. CT scan of the orbits. Calcified optic disc drusen are visible bilaterally at the posterior globe–optic nerve junction (arrows).

Part A courtesy of Steven A. Newman, MD; part B courtesy of Michael S. Lee, MD; parts C, E courtesy of Anthony C. Arnold, MD; part D courtesy of Hal Shaw, MD.

Image credit: Basic and Clinical Science Course, Section 5: Neuro-Ophthalmology. San Francisco: American Academy of Ophthalmology, 2018-2019: 142. Used with permission for educational purposes.