Unilateral buried optic nerve head drusen triggering central retinal vein occlusion in young – Discovering an eclipsed entity

Abstract

Optic nerve head (ONH) drusen are acellular calcified concretions. Buried drusen manifests as pseudopapilledema. The compressive effects of ONH drusen can rarely precipitate central retinal vein occlusion (CRVO). The superimposition of pseudopapilledema on disc edema in CRVO poses a diagnostic dilemma. A 40-year-old female without systemic comorbidities presented with resolving CRVO. An exhaustive systemic workup revealed no abnormalities. Ultrasonography demonstrated buried ONH drusen. This unusual etiology must be considered in a young patient in the absence of systemic risk factors, persistence of “nasally conspicuous” disc elevation, and presence of peripapillary hemorrhages. Ultrasonography must be incorporated in the diagnostic armamentarium in a young patient with CRVO.