June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Structure-Function Relationship in Optic Nerve Head Drusen
Author Affiliations & Notes
  • Stephanie Muylaert
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Sung Chul Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
  • Rafael Furlanetto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Yiyi Liu
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    New York Medical College, Valhalla, NY
  • Camila Netto
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
  • Rudrani Banik
    Department of Ophthalmology, New York Medical College, Valhalla, NY
    Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY
  • Jeffrey Liebmann
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York University School of Medicine, New York, NY
  • Robert Ritch
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY
    Department of Ophthalmology, New York Medical College, Valhalla, NY
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3235. doi:
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      Stephanie Muylaert, Sung Chul Park, Rafael Furlanetto, Yiyi Liu, Camila Netto, Rudrani Banik, Jeffrey Liebmann, Robert Ritch; Structure-Function Relationship in Optic Nerve Head Drusen. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3235.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To assess the relationship between optic nerve head drusen (ONHD) and retinal nerve fiber layer (RNFL) or visual field (VF) loss.

 
Methods
 

Patients with ultrasound B-scan positive ONHD and no other ocular or systemic disease that could affect RNFL or VF were recruited. Each participant had standard automated perimetry (SAP; 24-2 SITA-standard, Humphrey Field Analyzer), circumpapillary RNFL thickness measurement using optical coherence tomography (OCT), and serial enhanced depth imaging (EDI) OCT of the optic nerve head (interval between scans, ~30 μm). After delineating the ONHD mass in each EDI OCT scan, 3-dimensional images were created and ONHD volume was calculated for each eye. ONHD volume, RNFL thickness and VF sensitivity were correlated.

 
Results
 

37 eyes with ONHD (23 patients; mean age = 58±15 years) were included. Mean ONHD volume, VF mean deviation (MD), and RNFL thickness were 0.242±0.232 (range, 0.005 to 0.855) mm3, -4.5±4.6 (range, -17.0 to -0.1) dB and 76±19 (range, 42 to 113) µm, respectively. ONHD were most prevalent in the nasal quadrant (36 eyes, 97%), followed by superior, inferior and temporal quadrants (33 [89%], 28 [76%], and 15 [41%] eyes). 22 (59%) eyes had VF defects and 32 (86%) had focal or diffuse RNFL defects. ONHD volume had a moderate correlation with average RNFL thickness (p<0.001, R=-0.677; Fig A) and VF MD (p<0.001, R=-0.739; Fig B). 19 eyes had abnormal and asymmetric VF (mean VF sensitivity difference between hemifields > 1 dB). Among these 19 eyes, VF sensitivity was worse in the hemifield corresponding to the ONH side (superior vs. inferior half) with larger ONHD in 12 eyes (p=0.153, Cramér’s correlation coefficient V = 0.328), whereas RNFL was thinner in the same ONH side as larger ONHD in 14 eyes (p=0.027, Cramér’s V = 0.452).

 
Conclusions
 

ONHD mass is formed before detectable RNFL or VF loss. ONHD volume had a moderate correlation with RNFL thickness and VF MD. ONHD had a significant spatial correlation with RNFL, but not with SAP, probably because ONHD occur preferably in the nasal quadrant (Fig C-G).

 
 
(A) Relationship between ONHD volume and RNFL thickness. (B) Relationship between ONHD volume and VF MD. (C) White dotted arrow = location of EDI OCT scans (F). (D) Reconstructed ONHD mass (red and blue dots = Bruch’s membrane edges). (E) RNFL thickness sector map. (F) Red dotted circle = ONHD mass. (G) 24-2 Humphrey SITA-standard VF.
 
(A) Relationship between ONHD volume and RNFL thickness. (B) Relationship between ONHD volume and VF MD. (C) White dotted arrow = location of EDI OCT scans (F). (D) Reconstructed ONHD mass (red and blue dots = Bruch’s membrane edges). (E) RNFL thickness sector map. (F) Red dotted circle = ONHD mass. (G) 24-2 Humphrey SITA-standard VF.
 
Keywords: 627 optic disc • 504 drusen • 758 visual fields  
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