J Korean Ophthalmol Soc.  2015 Sep;56(9):1446-1453. 10.3341/jkos.2015.56.9.1446.

Optical Coherence Tomography Findings of Optic Nerve Head Drusen in Children and Adolescents

• Seo DR
• Park SH

• KMID: 2214562
• DOI: http://doi.org/10.3341/jkos.2015.56.9.1446

Abstract

PURPOSE
To analyze the features of optic nerve head drusen (ONHD) observed on the optical coherence tomography (OCT) of pediatric and adolescent patients and to compare the characteristics of diagnosed ONHD pediatric and adolescent patients with the control group.
METHODS
We performed a retrospective chart review of pediatric and adolescent patients with nasal elevation or marginal blurring of the optic nerve head on either direct ophthalmoscopic examination or fundus photography. Patients were compared with a control group of the same age who had normal optic nerve heads and no abnormal findings except refractive errors under ophthalmic examination including OCT.
RESULTS
There were 29 eyes (n = 16) with ONHD as a subretinal mass-like lesion on OCT among 84 eyes with nasal elevation or marginal blurring of the optic nerve head on OCT. Thirteen patients (18.8%) were diagnosed with ONHD in both eyes. The following 3 groups were compared: group 1, showing nasal elevation or marginal blurring of the optic nerve head on OCT and diagnosed with ONHD; group 2, without ONHD; group 3, normal controls. The spherical equivalent was significantly different among the groups (p < 0.001). Compared with group 3, group 1 showed peripapillary retinal nerve fiber layer thickening of the temporal area; however, there was no difference between groups 1 and 2.
CONCLUSIONS
Buried ONHD in children and adolescents may be asymptomatic and the diagnosis can be made when a subretinal mass-like lesion is detected on OCT.

Keyword

Buried optic nerve head drusen; Optical coherence tomography

MeSH Terms

Adolescent*
Child*
Diagnosis
Humans
Nerve Fibers
Optic Disk*
Optic Nerve*
Photography
Refractive Errors
Retinaldehyde
Retrospective Studies
Tomography, Optical Coherence*
Retinaldehyde

Figure

• 

  Figure 1 . Case of rapidly progressing buried optic nerve head drusen. (A) Right fundus photograph of 10 year-old male 2 years earlier. (B) Present fundus photograph presenting with nasal marginal blurring of the optic disc. (C-1) Infrared image shows a nasal elevation of the optic disc border. (C-2) A hyperreflective subretinal mass-like lesion (white arrow) is observed posterior to the outer plexiform and outer nuclear layers on the present spectral domain optical coherence tomography (SD-OCT).

• 

  Figure 2. Images showing the optic nerve head drusen of the right eye (A, C, E) and normal optic nerve head of the left eye (B, D, F). (A) Right fundus photograph presenting with optic disc swelling. (C) A focal hyper-reflective mass-like lesion (white arrow) is observed posterior to the outer plexiform and outer nuclear layers on SD-OCT. (E, F) The peripapillary RNFL thickness in each eye. SD-OCT = spectral domain optical coherence tomography; RNFL = retinal nerve fiber layer; TS = superotemporal; NS = superonasal; T = temporal; G = general; N = nasal; TI = inferotemporal; NI = inferonasal.

• 

  Figure 3. Images showing optic nerve head drusen of both eyes. (A, B) Fundus photographs presenting with optic disc swelling. (C, D) A focal hyperreflective mass-like lesion (white arrow) is seen posterior to the outer plexiform and outer nuclear layer on SD-OCT. (E, F) The peripapillary RNFL thickness in each eye. SD-OCT = spectral domain optical coherence tomography; RNFL = retinal nerve fiber layer; TS = superotemporal; NS = superonasal; T = temporal; G = general; N = nasal; TI = in-ferotemporal; NI = inferonasal.

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