Abstract
Purpose :
This study aimed to compare clinical and ophthalmic features between better eyes and worse eyes of adults with bilateral optic disc drusen (ODD).
Methods :
A database of 1010 ODD patients seen at Stanford Byers Eye Institute was established using International Classification of Diseases codes and natural language processing via the STAnford Research Repository (STARR). Forty-two patients (84 eyes) with bilateral ODD were included. The better eye and worse eye were assigned based on the mean deviation reported in the visual field exam. All structural changes in the optic disc head (ONH), assessed by enhanced depth imaging optical coherence tomography, were measured manually using Image-J software. The difference between the better eyes and worse eye was assessed using a paired t-test.
Results :
The average age of participants was 44.9 ± 17.3 years, with 89.1% being female and 61.9% being white. The better eyes had a better mean deviation of perimeter (-3.31 ± 6.41 vs. -8.06 ± 9.66, P < 0.001) and similar best-corrected visual acuity (LogMAR, 0.045 ± 0.12 vs. 0.060 ± 0.13, P = 0.460) compared with the worse eyes. The worse eyes had a significantly expanded ONH (Bruch’s membrane opening [BMO], 1658.2 ± 258.9 μm vs. 1588.2 ± 232.5 μm, P = 0.002; optic nerve head height 741.1 ± 160.6 μm vs. 685.4 ± 166.6 μm, P = 0.001) and a significantly larger volume of ODD presented by the mean area of ODD (0.77 ± 0.32 mm2 vs. 0.66 ± 0.34 mm2, P = 0.002), especially ODD over BMO (0.35 ± 0.23 mm2 vs. 0.28 ± 0.20 mm2, P < 0.001). No difference was found in the depth of the optic disc, volume of peripapillary hyperreflective ovoid mass-like structures, volume of ODD under BMO, or distributions of ODD.
Conclusions :
Shallow and larger ODD, and expanded ONH were associated with worse visual fields in patients with ODD, suggesting a need for close follow-up for patients with these features.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.