title: Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography.
abstract: OBJECTIVE
  To evaluate the efficacy of spectral-domain optical coherence tomography (SD-OCT) in differentiating optic disc edema (ODE) and optic nerve head drusen (ONHD) and to reveal the differential points.
  
  
  METHODS
  Comparative case series.
  
  
  METHODS
  Forty-five patients with ONHD, 15 patients with ODE, and 32 normal controls.
  
  
  METHODS
  Spectral-domain optical coherence tomography was performed with scans on the optic nerve head and measurements of retinal nerve fiber layer thickness.
  
  
  METHODS
  Qualitative findings of optic nerve head scans and retinal nerve fiber layer thickness profiles on SD-OCT.
  
  
  RESULTS
  Optic nerve head drusen was visualized as a focal, hyperreflective, subretinal mass with a discrete margin on SD-OCT. The retinal nerve fiber layer was deformed and showed pseudoedema and high reflectance. The outer nuclear layer smoothly covered the drusen, which led to a hyporeflective, boot-shaped area adjacent to the drusen. In ODE, peripapillary retinal nerve fiber layers were significantly thicker in all sections than ONHD (average thickness of ODE: 174.1±53.5 μm vs ONHD: 119.2±20.2 μm vs control: 103.4±19.1 μm, P<0.001). Retinal nerve fiber thickness in the nasal section provides a good differential marker for ODE from ONHD (area under receiver operating characteristic curve = 0.866).
  
  
  CONCLUSIONS
  With the use of SD-OCT, noninvasive and accurate differentiation of ONHD and ODE is possible.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Lee
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology; D015594:Optic Disk Drusen / Q000175:diagnosis*; D010211:Papilledema / Q000175:diagnosis*; D012372:ROC Curve; D012029:Refraction, Ocular / Q000502:physiology; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology