J Clin Neurol.  2012 Jun;8(2):151-154.

Bilateral Optic Disc Drusen Mimicking Papilledema

• Sahin A
• Cingu AK
• Ari S
• Cinar Y
• Caca I

Abstract

BACKGROUND
Optic disc drusen, which are calcified deposits that form anterior to the lamina cribrosa in the optic nerve, may mimic papilledema.
CASE REPORT
We report herein three cases referred to us with suspicion of disc swelling and papilledema. Following ophthalmologic evaluation with B-scan ultrasound, red-free fundus photography, and computed tomography, the diagnosis of papilledema was excluded in all cases and optic disc drusen was diagnosed.
CONCLUSIONS
Clinical suspicion of optic disc drusen in cases presenting with swelling of the optic nerve head is important in order to avoid unnecessary interventions and anxiety. The reported cases highlight the commonly encountered clinical presentations and the practical aspects of diagnosis and management of optic disc drusen.

Keyword

optic disc drusen; papilledema; differential diagnosis

MeSH Terms

Anxiety
Diagnosis, Differential
Hydrazines
Optic Disk
Optic Disk Drusen
Optic Nerve
Papilledema
Photography
Hydrazines

Figure

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  Fig. 1 The red-free fundus photographs of case 1, revealing autofluorescence of the optic discs.

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  Fig. 2 Axial CT of the brain and orbits of case 1. Note the hyper-dense area on both optic nerve heads due to calcification.

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  Fig. 3 B-scan ultrasonography of case 1 showing a hyperechoic region over the optic nerve head.

Reference

1. Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol. 2002. 47:515–532.

2. Tso MO. Pathology and pathogenesis of drusen of the optic nervehead. Ophthalmology. 1981. 88:1066–1080.

3. Davis PL, Jay WM. Optic nerve head drusen. Semin Ophthalmol. 2003. 18:222–242.

4. Lorentzen SE. Drusen of the optic disk, an irregularly dominant hereditary affection. Acta Ophthalmol (Copenh). 1961. 39:626–643.

5. Boldt HC, Byrne SF, DiBernardo C. Echographic evaluation of optic disc drusen. J Clin Neuroophthalmol. 1991. 11:85–91.

6. Antcliff RJ, Spalton DJ. Are optic disc drusen inherited? Ophthalmology. 1999. 106:1278–1281.

7. Wilkins JM, Pomeranz HD. Visual manifestations of visible and buried optic disc drusen. J Neuroophthalmol. 2004. 24:125–129.

8. Lee AG, Zimmerman MB. The rate of visual field loss in optic nerve head drusen. Am J Ophthalmol. 2005. 139:1062–1066.

9. Patel NN, Shulman JP, Chin KJ, Finger PT. Optical coherence tomography/scanning laser ophthalmoscopy imaging of optic nerve head drusen. Ophthalmic Surg Lasers Imaging. 2010. 41:614–621.

10. Kurz-Levin MM, Landau K. A comparison of imaging techniques for diagnosing drusen of the optic nerve head. Arch Ophthalmol. 1999. 117:1045–1049.