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VOLUME 52 , ISSUE 4ENG ( August, 2024 ) > List of Articles

Optic Disc Drusen: Diagnostic Challenge in Adult Patient

Melina Alejandra Franco, Daniel Badoza, María José Cosentino

Keywords : Optic disc drusen, OCT, pseudo papilledema, computed visual field, ocular ultrasound

Citation Information : Franco MA, Badoza D, Cosentino MJ. Optic Disc Drusen: Diagnostic Challenge in Adult Patient. 2024; 52 (4ENG):4-15.

DOI: 10.5005/hoe-10101-52401

Published Online: 31-07-2024

Copyright Statement:  Copyright © 2024; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: To describe a case of bilateral optic disc drusen as a finding in ophthalmological control in a 38-year-old female patient with no relevant personal history. Background: Optic disc drusen was first described in 1858 by Müller. Approximately 75% and 91% of clinical cases are bilateral. Although, in most cases, they are usually benign, they require periodic check-ups because their compressive effect on the optic nerve head can cause different comorbidities. Review of Results: A 38-year-old patient consulted on February 26, 2024, due to a visual alteration of the left eye after three months of evolution. She presented a best corrected visual acuity (BCVA) (evaluated with Snellen chart) of the right eye (RE) 20/20 and of the left eye (LE) 20/50. Biomicroscopy (BMC) of the right eye without particularities and the left eye with paracentral corneal leukoma that does not compromise the visual axis. Intraocular pressure (IOP) values within normal parameters and fundus examination of the right eye with no particularities and left eye with raised optic disc predominantly in the superior and temporal sectors, macula without alterations, and retina applied. Studies were requested to rule out optic neuritis as an ophthalmologic emergency and evaluation by a medical clinic. Subsequently, ocular ultrasound and autofluorescence were performed, which confirmed the diagnosis of bilateral optic disc drusen. As of May 27, 2024, the patient continues to have check-ups with no changes in her visual acuity and intraocular pressure values within normal parameters. Conclusion: Even in adult patients, optic disc drusen should be considered among the main differential diagnoses in the presence of an optic disc with an edematous appearance due to the comorbidities that it can bring in some groups of patients. The exact treatment and prevention of drusens are not yet known, but the treatment and control of the appearance of its comorbidities are known. Patients should undergo regular eye examinations focusing on IOP measurement, computed visual field (CVC), and retinal nerve fiber layer (RNFL) analysis. Clinical Importance: Diagnosis involves an arduous interdisciplinary workup accompanied by the ophthalmologist's diagnostic suspicion. Although they generally do not require treatment and usually have a good visual prognosis, they should always be checked periodically once the diagnosis has been made. It has been shown that optical coherence tomography (OCT) can help track the area of nerve fiber thinning that may cause visual field loss.


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