Fourier-domain optical coherence tomography and adaptive optics reveal nerve fiber layer loss and photoreceptor changes in a patient with optic nerve drusen.
BACKGROUND
New technology allows more precise definition of structural alterations of all retinal layers although it has not been used previously in cases of optic disc drusen.


METHODS
Using Stratus and Fourier domain (FD) optical coherence tomography (OCT) and adaptive optics (AO) through a flood-illuminated fundus camera, we studied the retinas of a patient with long-standing optic disc drusen and acute visual loss at high altitude attributed to ischemic optic neuropathy.


RESULTS
Stratus OCT and FD-OCT confirmed severe thinning of the retinal nerve fiber layer (RNFL). FD-OCT revealed disturbances in the photoreceptor layer heretofore not described in optic disc drusen patients. AO confirmed the FD-OCT findings in the photoreceptor layer and also showed reduced cone density at retinal locations associated with reduced visual sensitivity.


CONCLUSIONS
Based on this study, changes occur not only in the RNFL but also in the photoreceptor layer in optic nerve drusen complicated by ischemic optic neuropathy. This is the first reported application of FD-OCT and the AO to this condition. Such new imaging technology may in the future allow monitoring of disease progression more precisely and accurately.
Department of Ophthalmology and Vision Science, University of California at Davis, Sacramento, California 95817, USA.
Stacey S
SS
Choi
Robert J
RJ
Zawadzki
Mark A
MA
Greiner
John S
JS
Werner
John L
JL
Keltner
D000328:Adult; D000532:Altitude Sickness / Q000150:complications; D002560:Cerebrovascular Circulation / Q000502:physiology; D005583:Fourier Analysis; D006801:Humans; D000860:Hypoxia / Q000150:complications; D008297:Male; D009896:Optic Atrophy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D015594:Optic Disk Drusen / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D018917:Optic Neuropathy, Ischemic / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D055095:Optics and Photonics / Q000295:instrumentation; D010786:Photoreceptor Cells / Q000473:pathology*; D012161:Retinal Artery / Q000503:physiopathology; D017949:Retinal Cone Photoreceptor Cells / Q000473:pathology / Q000503:physiopathology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000295:instrumentation / Q000379:methods; D015354:Vision, Low / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014794:Visual Fields / Q000502:physiology