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Optic disc drusen in a child: diagnosis using noninvasive imaging tools
Avni Shah1, Bernard Szirth, Iris Sheng
1*MD †PhD Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, New Jersey.
Summary
Bilateral optic nerve head drusen (ONHD) were diagnosed in a pediatric patient using advanced imaging. Noninvasive techniques confirmed ONHD, ruling out serious conditions and reducing patient burden.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Medical Imaging
Background:
- Optic nerve head drusen (ONHD) are abnormal calcifications within the optic nerve head.
- Diagnosis in pediatric patients can be challenging and may require advanced imaging.
- Differentiating ONHD from other optic neuropathies is crucial for appropriate management.
Observation:
- A 15-year-old female with type 1 diabetes presented for routine screening.
- Fundus photography revealed disc elevation and altered neuroretinal rim in the left eye.
- Advanced imaging, including fundus autofluorescence, B-scan ultrasound, and optical coherence tomography, was employed.
Findings:
- Fundus autofluorescence showed hyperfluorescence, and blue channel analysis indicated nerve fiber layer elevation.
- B-scan ultrasound and A-scan revealed hyperechoic foci with posterior shadowing, indicative of bilateral drusen.
- Optical coherence tomography confirmed elevated optic nerve head structures consistent with drusen.
Implications:
- Complementary use of noninvasive imaging is vital for diagnosing ONHD in pediatric patients.
- Accurate diagnosis aids in excluding more serious optic nerve pathologies.
- Noninvasive methods reduce the need for invasive procedures, alleviating patient and family stress and costs.
