title: Using autofluorescence to detect optic nerve head drusen in children.
abstract: OBJECTIVE
  To assess the efficacy of using autofluorescence to identify optic nerve head drusen (ONHD) in children.
  
  
  METHODS
  We conducted a cross-sectional, descriptive study of subjects <18 years of age with possible pseudopapilledema due to ONHD. B-scan ultrasonography was considered the gold standard diagnostic technique. All participants underwent an extensive ophthalmic examination that included fundus color photography, autofluorescence analysis, and B-scan echography. ONHD were classified as visible or hidden. Autofluorescence images were analyzed by three observers who were masked to the results of B-scan ultrasonography.
  
  
  RESULTS
  A total of 24 children with pseudopapilledema were included. B-scan ultrasonography confirmed ONHD in 32 eyes of 18 patients (9 boys). Mean patient age was 12 years (range, 7-17 years). ONHD was bilateral in 14 patients; unilateral in 4. The majority of the drusen were hidden (26 of 32 eyes). Analysis of autofluorescence patterns identified the drusen in 94% of cases (30 of 32 eyes): visible, 100%; hidden, 92%. Interobserver agreement was high (κ = 0.91, κ = 0.96, κ = 0.89).
  
  
  CONCLUSIONS
  In this study cohort, autofluorescence proved a safe, fast, and reliable technique for identifying ONHD in children.
authors.affiliation: Ophthalmology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Health Sciences Faculty, Universidad Europea, Madrid, Spain. Electronic address: pgili@fhalcorcon.es.
authors.forename: Pablo
authors.initials: P
authors.lastname: Gili
authors.forename: Patricia
authors.initials: P
authors.lastname: Flores-Rodríguez
authors.forename: Julio
authors.initials: J
authors.lastname: Yangüela
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Herreros Fernández
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015785:Eye Diseases, Hereditary / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D015588:Observer Variation; D015594:Optic Disk Drusen / Q000150:complications / Q000175:diagnosis*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology; D061848:Optical Imaging / Q000379:methods*