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Buried disc drusen have hypo-reflective appearance on SD-OCT
Samantha Slotnick1, Jerome Sherman
1Department of Clinical Science, and SUNY Eye Institute, SUNY State College of Optometry, New York, New York 10036, USA. Think202020@gmail.com
Summary
Spectral domain optical coherence tomography (SD-OCT) reveals buried disc drusen as hyporeflective areas, aiding in differentiating them from papilledema. This non-invasive imaging technique offers new insights into optic nerve head pathology.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
- Medical Imaging
Background:
- Buried disc drusen are a critical differential diagnosis for papilledema.
- Spectral domain optical coherence tomography (SD-OCT) provides novel non-invasive methods for examining the optic nerve head.
- Understanding the SD-OCT appearance of drusen can help clinicians differentiate them from other optic nerve pathologies.
Observation:
- SD-OCT imaging of optic nerve heads with buried disc drusen revealed characteristic findings.
- Drusen appeared as rounded, hyporeflective areas, sometimes with a fine hyperreflective border.
- B-scan ultrasonography was used to confirm the presence of drusen and for comparison.
Findings:
- On SD-OCT, buried disc drusen present as hyporeflective areas, distinct from the hyperreflective appearance of calcified drusen on B-scan ultrasonography.
- These hyporeflective areas were observed at various depths within the optic nerve head in patients with confirmed buried drusen.
- The hyporeflective nature is hypothesized to result from a homogenous refractive index within the drusen, which OCT detects as a lack of optical reflectivity change.
Implications:
- SD-OCT offers a valuable tool for identifying buried disc drusen, particularly non-calcified ones where B-scan ultrasonography may be less informative.
- Accurate identification of buried disc drusen using SD-OCT can aid in ruling out papilledema, preventing unnecessary investigations and treatments.
- This imaging modality enhances diagnostic capabilities in neuro-ophthalmology, improving patient management for conditions affecting the optic nerve head.
