title: Histologic findings after surgical excision of optic nerve head drusen.
abstract: OBJECTIVE
  To report the histopathologic findings of a case of bilateral massive optic nerve head (ONH) drusen.
  
  
  METHODS
  A 59-year-old man presented with bilateral massive ONH drusen and secondary compromise of the retinal vasculature leading to vision of counting fingers at 1 ft in the left eye and 20/30 in the right eye. The inferior one half of the left ONH druse was excised resulting in no light perception vision postoperatively.
  
  
  RESULTS
  Energy-dispersive spectroscopy suggested the composition of the ONH druse to be calcium phosphate (Ca3[PO4]2), which has implications on pathogenesis of neuronal cell death in ONH drusen. Scanning electron microscopy demonstrated embedded metal particles, likely to be remnants of the instruments used.
  
  
  CONCLUSIONS
  Massive ONH drusen are actually one large druse that has multiple excrescences on its surface giving it the variegated appearance. Although surgical excision of ONH drusen may be technically possible, consideration should be given to improvements in instrumentation and patient selection criteria.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kapur
authors.forename: Jose S
authors.initials: JS
authors.lastname: Pulido
authors.forename: Jerrold L
authors.initials: JL
authors.lastname: Abraham
authors.forename: Mithlesh
authors.initials: M
authors.lastname: Sharma
authors.forename: Bruce
authors.initials: B
authors.lastname: Buerk
authors.forename: Deepak P
authors.initials: DP
authors.lastname: Edward
mesh_terms: D002130:Calcium Phosphates / Q000378:metabolism; D004577:Electron Probe Microanalysis; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D015594:Optic Disk Drusen / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D014821:Vitrectomy
chemical_list: D002130:Calcium Phosphates; C020243:calcium phosphate