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Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography
Kyoung Min Lee1, Se Joon Woo, Jeong-Min Hwang
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Purpose:
To evaluate the efficacy of spectral-domain optical coherence tomography (SD-OCT) in differentiating optic disc edema (ODE) and optic nerve head drusen (ONHD) and to reveal the differential points.
Design:
Comparative case series.
Participants:
Forty-five patients with ONHD, 15 patients with ODE, and 32 normal controls.
Methods:
Spectral-domain optical coherence tomography was performed with scans on the optic nerve head and measurements of retinal nerve fiber layer thickness.
Main Outcome Measures:
Qualitative findings of optic nerve head scans and retinal nerve fiber layer thickness profiles on SD-OCT.
Results:
Optic nerve head drusen was visualized as a focal, hyperreflective, subretinal mass with a discrete margin on SD-OCT. The retinal nerve fiber layer was deformed and showed pseudoedema and high reflectance. The outer nuclear layer smoothly covered the drusen, which led to a hyporeflective, boot-shaped area adjacent to the drusen. In ODE, peripapillary retinal nerve fiber layers were significantly thicker in all sections than ONHD (average thickness of ODE: 174.1±53.5 μm vs ONHD: 119.2±20.2 μm vs control: 103.4±19.1 μm, P<0.001). Retinal nerve fiber thickness in the nasal section provides a good differential marker for ODE from ONHD (area under receiver operating characteristic curve = 0.866).
Conclusions:
With the use of SD-OCT, noninvasive and accurate differentiation of ONHD and ODE is possible.
