title: Advanced visual field loss secondary to optic nerve head drusen: case report and literature review.
abstract: 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.
authors.affiliation: W.G. Hefner VA Medical Center, Salisbury, North Carolina, USA. robert.morris2@va.gov
authors.forename: Robert W
authors.initials: RW
authors.lastname: Morris
authors.forename: Joy M
authors.initials: JM
authors.lastname: Ellerbrock
authors.forename: Ania M
authors.initials: AM
authors.lastname: Hamp
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Joy
authors.forename: Philip
authors.initials: P
authors.lastname: Roels
authors.forename: Charles N
authors.initials: CN
authors.lastname: Davis
mesh_terms: 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