Abstract
Purpose :
Optical coherence tomography (OCT) has been used to detect optic nerve head drusen(ONHD) but , the buried ONHD are still difficult to detect reliably .This study aims to further define the characteristics of ONHD on spectral domain (SD) OCT.
Methods :
We analysed the OCT images and videos of 182 eyes of 100 subjects with clinical diagnosis of ONHD on fundus examination with no signs and symptoms suggestive of raised intracranial tension presenting from January 2011 to May 2019 at a tertiary referral institute in south India. The clinical profile and the morphologic features of ONHD using Cirrus SD OCT were studied .The study was approved by the Institutional Review Board of Vision Research Foundation.
Results :
Of the 100 subjects ,29 were males and 71 females. The median age of the subjects was 33 years (range 10-78 years).Of the 182 eyes, buried ONHD was found in 145 (79.6%) eyes and superficial ONHD in 37 (20.4%) eyes. The mean age for the presence of superficial drusen was 54.10 years and that for buried drusen was 28.45 years. ONHD was seen in the nasal quadrant in 109 eyes , followed by the superior quadrant in 30 eyes. Round ONHD was seen in 112 eyes (61.5%), 58 eyes (31.9%) showed oval ONHD and 12 eyes (6.6%) had ONHD which was diffuse in shape .Of the 145 buried drusen, 116 eyes (80%) showed homogenous internal reflectivity and 29 (20%) showed non homogenous reflectivity. Of 37 superficial drusen, 20 eyes (54%) showed homogenous and 17(46%) showed non-homogenous internal reflectivity .Among the 37 eyes with superficial drusen, 23 eyes (62.2%) exhibited hyperreflective borders and of the 145 eyes with buried drusen only 6(4.1%) had a hyperreflective border. Bilateral ONHD were noticed in 82% of subjects. More than one drusen was noted in 11% of cases. The mean disc area for superficial drusen was 2.16 ± 0.512 mm2 and that for buried drusen was 2.07 ± 0.464 mm2.
Conclusions :
The mean age at which superficial drusen is seen is significantly high when compared to that of buried drusen .Majority of drusen were round in shape and most commonly located in the nasal quadrant. The internal reflectivity of the ONHD on SD OCT was homogenous in three fourth of the eyes and it showed non homogenous internal reflectivity in one fourth of the eyes. Hyper-reflective border surrounding the drusen was mostly seen in superficial drusen.
This is a 2020 ARVO Annual Meeting abstract.