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Optic disc drusen in children
D L Hoover1, R M Robb, R A Petersen
1Department of Ophthalmology, Children's Hospital, Boston, Massachusetts.
Insights
Optic disc drusen in children often lead to pseudopapilledema. Hyaline bodies and visual field deficits commonly emerge in the second decade of life.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Neuro-ophthalmology
Background:
- Pseudopapilledema can mimic serious conditions like papilledema.
- Optic disc drusen are a common cause of pseudopapilledema.
- Understanding the natural history in children is crucial for diagnosis and management.
Purpose of the Study:
- To characterize the early natural history of pseudopapilledema due to optic disc drusen in children.
- To identify the typical age of onset for key findings.
- To assess the incidence of visual acuity and visual field deficits.
Main Methods:
- Retrospective study of 40 children with pseudopapilledema.
- Analysis of patient age at first examination and follow-up duration.
- Documentation of optic disc drusen appearance, visual acuity, and visual field defects.
Main Results:
- Discrete hyaline bodies or calcifications appeared in 38/40 cases by a mean age of 12.1 years.
- Visual acuity loss was rare, occurring in only one eye due to neovascularization.
- Visual field deficits were detected in 18/35 eyes, including enlarged blind spots and arcuate defects.
Conclusions:
- Papillary calcifications or hyaline bodies frequently emerge in the second decade of life in children with optic disc drusen.
- Visual field deficits are commonly detectable during this period.
- Pseudopapilledema due to optic disc drusen has a generally benign early natural history regarding visual acuity.
Abstract:
Forty children with pseudopapilledema due to optic disc drusen (31 bilateral, nine unilateral) were studied retrospectively to characterize the early natural history of this condition. The average age at the first examination was 10.2 years (range 3.6 to 19.5 years), and the mean follow-up period was 44 months. Discrete hyaline bodies or papillary calcifications were first noted in one or both eyes with pseudopapilledema at a mean age of 12.1 years in 38 of 40 cases. Decreased visual acuity due to drusen occurred in only one eye due to subretinal neovascularization. Visual fields obtained in 35 eyes (21 patients) with pseudopapilledema showed an enlarged blind spot (9), an inferior arcuate/sector/or altitudinal defect (6), or both (3) in 18 eyes. Our study suggests that discrete papillary calcifications or hyaline bodies frequently emerge and visual field deficits are commonly detectable in the second decade of life in patients with pseudopapilledema due to optic disc drusen.