Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

Malmqvist, Lasse; Lindberg, Anne-Sofie Wessel; Dahl, Vedrana Andersen; Jørgensen, Thomas Martini; Hamann, Steffen

doi:10.1167/iovs.17-21608

Cited by 40 publications

(36 citation statements)

References 36 publications

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“…Several ancillary tests, including ophthalmic ultrasound (US), orbital computed tomography (CT), fundus auto-fluorescence (FAF), fluorescein angiography (FA), and optical coherence tomography (OCT), have been used to identify ODD [ 7 ]. The role of OCT to diagnose ODD has expanded in the recent years, especially with the development of enhanced depth imaging OCT (EDI-OCT), which has its highest sensitivity near the inner sclera and is thereby excellent in visualising buried ODD [ 8 – 10 ]. In the last few years, there have been conflicting descriptions of ODD morphology on OCT. Generally the ODD were described as a signal-poor core mass surrounded by a hyperreflective margin [ 8 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…The role of OCT to diagnose ODD has expanded in the recent years, especially with the development of enhanced depth imaging OCT (EDI-OCT), which has its highest sensitivity near the inner sclera and is thereby excellent in visualising buried ODD [ 8 – 10 ]. In the last few years, there have been conflicting descriptions of ODD morphology on OCT. Generally the ODD were described as a signal-poor core mass surrounded by a hyperreflective margin [ 8 – 12 ]. However, other studies described ODD as hyperreflective structures or with both hypo- and hyper-reflective internal reflectivity [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, other studies described ODD as hyperreflective structures or with both hypo- and hyper-reflective internal reflectivity [ 12 , 13 ]. A critical appraisal regarding this description has been raised by some authors [ 8 , 14 ]. Hyperreflective mass-like structures, almost always located in the peripapillary circumference appear in patients with ODD although, they are also present in patients with intracranial hypertension [ 8 , 15 ] or with optic nerve tumours [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Optic disc drusen in children: morphologic features using EDI-OCT

Teixeira

Marques

Mano

et al. 2019

Eye

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Aims This study aimed to investigate morphologic features of optic disc drusen (ODD) and peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children, using enhanced depth imaging optical coherence tomography (EDI-OCT). It also assessed if the presence of these features were associated with decreased peripapillary retinal nerve fibre layer (RNFL) thickness. Methods Retrospective observational study of children with ODD. All subjects underwent complete ophthalmic examination and multimodal imaging. ODD were identified on EDI-OCT as circumscribed hyporeflective spheroidal elements located in front of lamina cribrosa, fully or partially surrounded by a hyperreflective border. PHOMS were identified as hyperreflective ovoid structures located in the peripapillary circumference. Both associations between ODD and RNFL loss and PHOMS and RNFL loss were tested using chi-squared test. Results In total, 38 eyes of 20 children were analysed. PHOMS were present in 90% of patients. ODD and PHOMS were predominantly found in the nasal, superonasal and inferonasal sectors. A significant positive association was found between ODD and decreased RNFL thickness in the nasal ( p = 0.02), superonasal ( p = 0.05) and inferotemporal ( p = 0.04) sectors. There was no significant association found with the presence of PHOMS. Conclusion EDI-OCT allowed morphological analysis of ODD and PHOMS in children. Drusen were found to be distinct from PHOMS both in their appearance and impact on the RNFL. ODD are hyporeflective and appear on the ONH above the lamina cribrosa and were associated with decreased thickness of the RNFL. On the contrary, PHOMS are hyperreflective structures located around the ONH and were not associated with RNFL loss.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Optic disc drusen in children: morphologic features using EDI-OCT

Teixeira

Marques

Mano

et al. 2019

Eye

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“…After exclusion of the effect of RNFL thinning, the height of ODD associated protrusion was associated with the presence of an enlarged blind spot ( Table 2 ). The association between ODD sizes and visual field defects was previously reported [ 7 , 8 , 30 ]. We suspect that the direct effect of ODD on the optic nerve axon, such as blockage of axonal transport or circulatory disturbance, may be responsible for the decrease in visual sensitivity near the blind spot.…”

Section: Discussionmentioning

confidence: 53%

“…The introduction of spectral-domain optical coherence tomography (SD-OCT) marked a paradigm shift for the diagnosis of ODD. It became possible to image the acellular deposits in the optic nerve head with or without, a border of high reflectance of calcification [ 3 – 8 ]. Moreover, buried ODD without a highly reflective border have different characteristics compared with visible ODD or buried ODD with a highly reflective border [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with visual field defects of optic disc drusen

2018

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PurposeTo investigate the prevalence and risk factors for visual field defect in patients with optic disc drusen (ODD).MethodsWe assessed the visual field status of patients with ODD whose diagnosis were confirmed by spectral-domain optical coherence tomography (SD-OCT). Visual field defects were classified as normal, enlarged blind spot, or other defects. ODD were classified into either type 1 (without hyperreflective border and heterogenic internal reflectance) or type 2 (with hyperreflective border and lower internal reflectance). The prevalence and risk factors for each visual field defect was analyzed using logistic regression analysis and classification and regression tree (CART) modeling.ResultsOf the 40 eyes with ODD, 33 (83%) eyes were categorized as type 1 and 7 (17%) eyes were categorized as type 2 ODD. Regarding the visual field defects, 19 (48%) eyes showed normal visual field, 11 (28%) eyes showed enlarged blind spot, and 9 (24%) eyes showed other defects. The latter was more frequent in type 2 ODD (P = 0.001). Logistic regression analysis revealed that the factor associated with other defects was the thinning of the average retinal nerve fiber layer (RNFL) (per 10 μm decrease, OR = 3.436, P = 0.004), and the factor associated with enlarged blind spot was the height of ODD (per 100 μm increase, OR = 3.956, P = 0.023). CART modeling revealed that the average RNFL thickness lesser than 85.5 μm, and then the ODD height larger than 348 μm were the best split-up factors for predicting the type of visual field defects.ConclusionsIn this study, one-quarter of ODD patients showed abnormal visual field defect other than enlarged blind spot. These other visual field defects appeared to be associated with the axonal loss in the eyes with type 2 ODD.

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Substantial Visual Field Loss Associated With Giant Optic Disc Drusen

2017

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We diagnosed a white woman in her early 60s with giant optic disc drusen causing extensive visual field defects bilaterally. Her bestcorrected visual acuity was 1.0 (approximate Snellen equivalent, 20/20) OU. Automated perimetric mean deviation was -19.5 dB in the right eye and -17.7 dB in the left eye. Optic disc drusen were defined as hyporeflective structures with a hyperreflective margin using optical coherence tomography (Figure , A). Optic disc drusen, inner limiting membrane, and Bruch membrane were segmented from the right optic nerve head using enhanced depth imaging optical coherence tomography scans and a specialized algorithm (Figure , B). 1 The total optic disc drusen volume was 1.9 mm 3 , comprising 66% of the optic nerve head volume of 2.9 mm 3 . The patient's visual field loss warranted suspension of her driver's license. This case demonstrates that optic disc drusen, even without concomitant disease such as anterior ischemic optic neuropathy, can be associated with substantial visual field loss.

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Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

Abstract: Large ODD volume is associated with optic nerve dysfunction. The worse visual field defects associated with visible ODD should only be ascribed to larger ODD volume and not to a more superficial anatomic ODD location.

Cited by 40 publications

References 36 publications

Optic disc drusen in children: morphologic features using EDI-OCT

Optic disc drusen in children: morphologic features using EDI-OCT

Factors associated with visual field defects of optic disc drusen

Substantial Visual Field Loss Associated With Giant Optic Disc Drusen

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