Advanced visual field loss secondary to optic nerve head drusen: case report and literature review.
BACKGROUND
Optic nerve head drusen (ONHD) is a relatively uncommon condition that results from calcific degeneration of axons within the optic nerve. The abnormal drusen bodies can enlarge, compressing normal nerve structures, and ultimately may result in vision loss. Drusen often are discovered through clinical evaluation with a dilated funduscopic examination. Ancillary testing, including computed tomographic (CT) imaging, B-scan ultrasonography, autofluorescence imaging, nerve fiber layer imaging, and threshold visual field evaluation are helpful to confirm the existence of ONHD and to evaluate for progression of this condition.


METHODS
This case report discusses the clinical presentation of a patient with advanced visual field loss from ONHD and the ancillary testing used to confirm the diagnosis. A complete review of literature on ONHD is discussed.


CONCLUSIONS
Currently, there is no cure or direct treatment for progressive vision loss or complications that may develop from ONHD. Useful diagnostic tools include serial automated threshold visual fields, nerve fiber layer analysis, and fundus photography. It is suggested that ocular hypotensive agents be used to lower intraocular pressure prophylactically to prevent further nerve fiber layer and optic nerve damage.
Morris
Robert W
RW
W.G. Hefner VA Medical Center, Salisbury, North Carolina, USA. robert.morris2@va.gov
Ellerbrock
Joy M
JM
Hamp
Ania M
AM
Joy
Jeffrey T
JT
Roels
Philip
P
Davis
Charles N
CN
D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D015594:Optic Disk Drusen / Q000150:complications* / Q000175:diagnosis; D012607:Scotoma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D014794:Visual Fields