Posters

Optic disc drusen with rapid VF defect progression: a case report

Poster Details

First Author: T.Stavropoulou UK

Co Author(s):    D. Pagoulatos   P. Dimitrakas   E. Lazari   K. Papadedes           

Abstract Details

Purpose:

Optic disc drusen are often incidental findings discovered during routine eye examinations. They are found in approximately 1% of the population and they have bilateral distribution in 75% of the cases. Drusen are depositions of mucopolysaccharides and proteinaceous material that accumulate anterior to the lamina cribosa within the optic nerve head. Patients with optic disc drusen are often asymptomatic, but VF defects might be present

Setting:

NHS Derriford Hospital. Plymouth, UK

Methods:

We present a case of a 47 year old Caucasian male than presented in our general clinic with gradual decrease of vision in his left eye. Upon examination the visual acuity was 6/4 in the right eye and 6/60 in the left eye. The IOP in BE was 12 mmHg and the central corneal thickness was 550 in the RE and 549 in the LE. Upon clinical examination the only finding was optic disc drusen. Finding that was confirmed with autofluresence and OCT of the optic disc. There was significant constriction of the VFs in BE and significant RNFL defects.

Results:

Topical treatment with Alphagan was suggested in BE, three times per day Patient was reviewed 6 months after initiation of treatment . The visual acuity in his left eye was further decreased reaching hand movement but the central VF acuity of the right eye was maintained . Both eyes had significant progression of the VF constrictions. Six months further into treatment with Alphagan three times per day the VA of the patient and the VFs had stabilize.

Conclusions:

No definitive treatment currently exists for optic nerve drusen. Patients with documented optic nerve drusen should be followed  up with visual field examination , optic nerve fiber analysis, and repeat intraocular pressure checks. If visual field loss occurs in the presence of drusen, medication to lower intraocular pressure should be considered.

Financial Disclosure:

None