Substantial Visual Field Loss Associated With Giant Optic Disc Drusen

Malmqvist, Lasse; Kyhnel, Alexander; Hamann, Steffen

doi:10.1001/jamaophthalmol.2017.4778

Cited by 5 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is an observation that, for example, can be made with ODD causing progressive visual field defects. 18 The known association between more severe retinal inner layer atrophy and progression of disability on the EDSS 19 cannot be shown for PHOMS. There was no relationship between PHOMS and use of DMTs.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal Development of Peripapillary Hyper‐Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in Multiple Sclerosis

Petzold

Coric²,

Balk³

et al. 2020

Annals of Neurology

Self Cite

View full text Add to dashboard Cite

Objective Peripapillary hyper‐reflective ovoid masslike structures (PHOMS) are a new spectral domain optical coherence tomography (OCT) finding. Methods This prospective, longitudinal study included patients (n = 212) with multiple sclerosis (MS; n = 418 eyes), 59 healthy controls (HCs; n = 117 eyes), and 267 non‐MS disease controls (534 eyes). OCT and diffusion tensor imaging were used. Results There were no PHOMS in HC eyes (0/117, 0%). The prevalence of PHOMS was significantly higher in patients with MS (34/212, p = 0.001) and MS eyes (45/418, p = 0.0002) when compared to HCs (0/59, 0/117). The inter‐rater agreement for PHOMS was 97.9% (kappa = 0.951). PHOMS were present in 16% of patients with relapsing–remitting, 16% of patients with progressive, and 12% of patients with secondary progressive disease course (2% of eyes). There was no relationship of PHOMS with age, disease duration, disease course, disability, or disease‐modifying treatments. The fractional anisotropy of the optic radiations was lower in patients without PHOMS (0.814) when compared to patients with PHOMS (0.845, p = 0.03). The majority of PHOMS remained stable, but increase in size and de novo development of PHOMS were also observed. In non‐MS disease controls, PHOMS were observed in intracranial hypertension (62%), optic disc drusen (47%), anomalous optic discs (44%), isolated optic neuritis (19%), and optic atrophy (12%). Interpretation These data suggest that PHOMS are a novel finding in MS pathology. Future research is needed to determine whether development of PHOMS in MS is due to intermittently raised intracranial pressure or an otherwise impaired “glymphatic” outflow from eye to brain. ANN NEUROL 2020;88:309–319.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Again, the finding was confirmed by the data from the non‐MS cohort for optic atrophy. This is an observation that, for example, can be made with ODD causing progressive visual field defects 18 . The known association between more severe retinal inner layer atrophy and progression of disability on the EDSS 19 cannot be shown for PHOMS.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Development of Peripapillary Hyper‐Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in Multiple Sclerosis

Petzold

Coric²,

Balk³

et al. 2020

Annals of Neurology

Self Cite

View full text Add to dashboard Cite

show abstract

“…68 Visual acuity and colour vision are usually normal throughout life, although rare cases of blindness or severe field loss due to ONHD are reported. 69,70 Many of these cases with severe vision loss are presumed to be complicated by an ischaemic optic neuropathy (see complications below).…”

Section: Visual Function and Prognosismentioning

confidence: 99%

Optic Nerve Head Drusen: An Update

Palmer

Gale

Crowston

et al. 2018

Neuro-Ophthalmology

View full text Add to dashboard Cite

Optic nerve head drusen are benign acellular calcium concretions that usually form early in life, just anterior to the lamina cribrosa. Improving imaging using optical coherence tomography suggests they are common and may be present in many clinically normal discs. These drusen may change in appearance in early life, but are generally stable in adulthood, and may be associated with visual field defects, anterior ischaemic optic neuropathy, or rarer complications. Based on long-term clinical data and optical coherence tomography, we propose a refined hypothesis as to the cause of optic disc drusen. Here we summarise recent findings and suggest future studies to better understand the forces involved.

show abstract

“…2 These field defects vary widely in the degree of their severity, and in rare circumstances can lead to significant visual impairment. [6][7][8][9] Legal blindness is defined in both the United States and Canada as a best corrected visual acuity of 20/200 or less in the better eye, or a visual field constriction of 20 degrees or less. 10,11 Although it is not a true indication of functional status, this classification is used to determine eligibility for programs such as vocational training, rehabilitation, and tax exemp-…”

Section: Introductionmentioning

confidence: 99%

Case of Legal Blindness Secondary to Optic Nerve Head Drusen

Bennett

2022

CJO

View full text Add to dashboard Cite

Optic nerve head drusen are relatively infrequent abnormalities of the optic disc that are usually discovered as incidental findings during a routine eye examination. While typically considered to be benign, visual field loss due to the drusen is not uncommon. Visual field defects are more prevalent in superficial drusen than buried drusen, and can present as nerve fiber bundle defects, generalized concentric constriction, or enlargement of the blind spot. The extent of damage is variable, but it is rare that the degree of field loss leads to substantial functional impairment. This case presents a patient with significant bilateral concentric field loss secondary to optic nerve drusen that caused severe visual impairment and disability.

show abstract

Substantial Visual Field Loss Associated With Giant Optic Disc Drusen

Cited by 5 publications

References 1 publication

Longitudinal Development of Peripapillary Hyper‐Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in Multiple Sclerosis

Longitudinal Development of Peripapillary Hyper‐Reflective Ovoid Masslike Structures Suggests a Novel Pathological Pathway in Multiple Sclerosis

Optic Nerve Head Drusen: An Update

Case of Legal Blindness Secondary to Optic Nerve Head Drusen

Contact Info

Product

Resources

About