Abstract
Background: :
There are no prospective studies that evaluate the visual field progression (VFP) in patients with optic disc drusen (ODD).
Purpose: :
To evaluate the 1.1. overall frequency of visual field loss (VFL) and 1.2. visual field progression (VFP) 2.1. age related frequency of VFP in age groups and 1.2. amount of VFP in age groups 3. frequency of acute vascular ODD related disorders and concomitant disorders
Methods: :
113 ODD patients (207 eyes) were consecutively examined and standardized documented in a prospective study between 1987 and 2004. Out of these 46 patients (80 eyes) were re–examined and met the inclusion criteria: reliable visual field examinations, no other disease which can cause a Visual field loss (VFL), follow up re–examination minimum after 21 months. VFL was staged according to the classification of Aulhorn. The 46 patients were categorized into 4 age groups: I. 0–20, II. 21–40, III. 41–60, IV. 61–80 years. Spearman–Rho Test was used for statistics.
Results: :
1.1. 44 of 80 eyes (55%) with perimetric long term follow up had a pre–existing VFL. 36 of 80 eyes (45%) had no VFL, 20 (25%) had VFL stage I, 16 (20%) stage II, 4 (5%) stage III, 4 (5%) stage IV. 1.2. 31 of 80 eyes (39%) showed a VFP during a mean observation time of 84 months. No VFP showed 49 eyes (61%) during a mean observation time of 71 months. 2.1. There was with increasing age a significantly increasing frequency of VF deterioration (age group I:17%, age group II:29%, age group III:39%, age group IV:56%) (p<0,01) 2.2. Comparing 4 age groups we found with increasing age an increasing amount of VFP (p<0,01). The VFP in age group I showed in a mean follow up period of 98 months a mean VFL deterioration of +0,33 (+/–1,07) stages, age group II: mean follow up period: 88 months, mean VFL deterioration: +0,29 (+/–0,41) stages, age group III: mean follow up period: 73 months, mean VFL deterioration: +0,5 (+/–0,67) stages and age group IV: mean follow up period: 61 months, mean VFL deterioration: +1,1 (+/–1,0) stages. 3. Out of the total of 113 eyes the frequency of vascular disorders at the first examination was: 8 eyes (7,1%) non arteritic anterior ischemic optic neuropathy (NAION), 2 eyes (1,7%) retinal artery occlusion, 1 eye (0,9%) retinopathia centralis serosa. Concomitant disorders: 5 eyes (4,4%) with glaucoma, 7 eyes (6,2%) AMD, 3 eyes (2,7%) diabetic retinopathy and one eye (0,9%) with retinitis pigmentosa.
Conclusions: :
The results confirm that ODD is a progressive optic nerve disease. 31 of 80 eyes showed a detoriation of the VF. The older the ODD patient the higher the VFL and the higher the progression of VFL.