In-vivo high resolution imaging of optic nerve head drusen using spectral-domain Optical Coherence Tomography.
BACKGROUND
Optic nerve head drusen (ONHD) are white calcareous deposits, seen either superficially on the optic nerve head or buried within it. Diagnosis of ONHD is made by one or more ways: clinical exam, autofluorescence, ultrasound of the optic nerve, CT scan and/or visual field examination. The present study describes features of ONHD based on another diagnostic modality, the spectral-domain OCT (Spectralis).


METHODS
This is a retrospective case series of 5 patients with bilateral ONHD with a best-corrected visual acuity of 20/20 and no other posterior segment pathology. All the patients underwent fundus photography, fundus autofluorescence, B-scan ultrasonography, Spectralis OCT and Humphrey 30-2 threshold visual fields.


RESULTS
All 5 patients had surface ONHD which were autofluorescent and echodense on B-scan ultrasonography. Spectralis OCT findings in the corresponding areas include 'scattered spots with high reflectivity' casting a shadow underneath. The reflectivity can be distinctly differentiated from the blood vessels on the optic nerve. Two patients had an arcuate scotoma on the Humphrey visual fields. No correlation was found between the changes on Spectralis OCT with that of visual field.


CONCLUSIONS
Spectralis OCT is another useful ancillary investigation in the diagnosis of ONHD and we describe the features in the present study.
Department of Ophthalmology, College of Medicine, University of Florida, Jacksonville, Florida, USA.
Ravi K
RK
Murthy
Laura
L
Storm
Sandeep
S
Grover
Vikram S
VS
Brar
Kakarla V
KV
Chalam
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015594:Optic Disk Drusen / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult