Radial Optic Neurotomy to Treat Patients with Visual Field Defects Associated with Optic Nerve Drusen

Nentwich, Martin M.; Remy, Matthias; Haritoglou, Christos

doi:10.1097/iae.0b013e318209b748

Cited by 16 publications

(11 citation statements)

References 4 publications

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“…Surgical treatment of visual field defects due to optic disc drusen with optic nerve sheath fenestration or radial optic neurotomy is controversial and not considered standard of care, but success has been reported by a few authors. 85; 86; 129; 146 …”

Section: Treatmentmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

112

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Optic disc drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disc drusen, particularly when buried, to simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disc drusen. Complications of optic disc drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, non-arteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for choroidal neovascular membranes. In most cases, however, children with optic disc drusen can be managed by observation with serial examinations and visual field testing, once true optic disc edema has been excluded.

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Section: Treatmentmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

112

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“…Further research using EDI-OCT and SS-OCT may identify risk factors associated with drusen-related visual field loss and help provide prognostic information. Although there are presently no known treatments for drusen-related field loss, improved understanding of the mechanism of neuronal damage through enhanced imaging may lead to developments in this area (44). …”

Section: Discussionmentioning

confidence: 99%

Assessment of Optic Nerve Head Drusen Using Enhanced Depth Imaging and Swept Source Optical Coherence Tomography

Silverman¹,

Tatham²,

Medeiros³

et al. 2014

Journal of Neuro-Ophthalmology

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Background Optic nerve head drusen (ONHD) are calcific deposits buried or at the surface of the optic disc. Although ONHD may be associated with progressive visual field defects, the mechanism of drusen-related field loss is poorly understood. Methods for detecting and imaging disc drusen include B-scan ultrasonography, fundus autofluorescence, and optical coherence tomography (OCT). These modalities are useful for drusen detection but are limited by low resolution or poor penetration of deep structures. This review was designed to assess the potential role of new OCT technologies in imaging ONHD. Evidence Acquisition Critical appraisal of published literature and comparison of new imaging devices to established technology. Results The new imaging modalities of enhanced depth imaging optical coherence tomography (EDI-OCT) and swept source optical coherence tomography (SS-OCT) are able to provide unprecedented in vivo detail of ONHD. Using these devices it is now possible to quantify optic disc drusen dimensions and assess integrity of neighboring retinal structures, including the retinal nerve fiber layer. Conclusions EDI-OCT and SS-OCT have the potential to allow better detection of longitudinal changes in drusen and neural retina and improve our understanding of drusen-related visual field loss.

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“…However, this surgical technique is relatively invasive. Nentwich et al presented a case series of six patients with visual field defects associated with optic nerve drusen [15]. All patients were treated with RON.…”

Section: Discussionmentioning

confidence: 99%