Visual manifestations of visible and buried optic disc drusen.
BACKGROUND
It has been reported that visible optic disc drusen are associated with decreased visual acuity and loss of peripheral visual field. Patients with buried optic disc drusen have not been as well characterized.


METHODS
An observational, retrospective review was made of 92 eyes with funduscopic or ultrasonographic evidence of optic disc drusen. Demographics, presenting symptoms, visual acuity, refractive error, intraocular pressure, presence of an afferent pupillary defect, cup-to-disc ratio, appearance of the optic nerve, and visual field were recorded.


RESULTS
Fifty-one (55%) of the eyes were symptomatic; among them, 63% had symptoms of visual acuity loss, and 49% had symptoms of visual field loss. Seventy-nine (86%) of the optic discs appeared abnormal on ophthalmoscopy, but only 42% of these had visible drusen. Forty-five (49%) of the eyes had a visual field defect, and 73% of these were nerve fiber bundle in type. Overall, 73% of optic discs with visible drusen had abnormal visual fields compared with only 36% of optic discs with buried drusen (P < 0.05).


CONCLUSIONS
Among 92 eyes with optic disc drusen, only slightly more than 50% produced visual symptoms. Fewer than 50% of drusen were visible ophthalmoscopically. Buried optic disc drusen identified by ultrasound had a significantly lower frequency of associated visual field defects than did visible optic disc drusen.
Wilkins
Jay M
JM
Department of Ophthalmology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, USA.
Pomeranz
Howard D
HD
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D015594:Optic Disk Drusen / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D011681:Pupil Disorders / Q000150:complications; D012189:Retrospective Studies; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields