Optic Nerve Drussen

Optic Nerve Drusen:

These are refractile deposits within the substance of the optic nerve head.

They are unrelated to drusen of the retina, which occur in age-related macular degeneration. Optic disc drusen are most common in people of northern European descent.

Their diagnosis is obvious when they are visible as glittering particles upon the surface of the optic disc. However, in many patients they are hidden beneath the surface, producing pseudo-papilledema.

It is important to recognize optic disc drusen to avoid an unneccessary evaluation for papilledema.

Ultrasound or computed tomography (CT) scanning is sensitive for detection of buried optic disc drusen because they contain calcium.

In most patients, optic disc drusen are an incidental, innocuous finding, but they can produce visual obscurations.

On perimetry they give rise to enlarged blind spots and arcuate scotomas from damage to the optic disc. With increasing age, drusen tend to become more exposed on the disc surface as optic atrophy develops. Hemorrhage, choroidal neovascular membrane, and aion are more likely to occur in patients with optic disc drusen. No treatment is available.