[Optic Disk Drusen: Historical and Up-To-Date Aspects].

Area of Science:

• Ophthalmology
• Neuro-ophthalmology

Background:

• Optic disc drusen are a key consideration in diagnosing a prominent optic nerve head.
• Prevalence ranges from 0.34% to 2.4% in the general population, typically bilateral (75% of cases).
• Histological examination reveals drusen six times more frequently than funduscopic findings.

Purpose of the Study:

• To provide a comprehensive overview of optic disc drusen.
• To discuss diagnostic modalities and potential associated conditions.
• To highlight management strategies for visual field defects.

Main Methods:

• Review of existing literature on optic disc drusen.
• Discussion of non-invasive diagnostic tools: fundus-autofluorescence (AF), optical coherence tomography (OCT), and ultrasound.
• Emphasis on clinical examination, including tonometry and perimetry for visual field assessment.

Main Results:

• Optic disc drusen can occur in familial clusters and are associated with retinitis pigmentosa, Joubert syndrome, and Alagille syndrome.
• While often asymptomatic, superficial drusen can cause significant adult visual field defects.
• Transient visual impairment may result from transient ischemia.

Conclusions:

• Regular ophthalmological follow-up, including tonometry and perimetry, is essential for early detection of visual field defects.
• Radial optic neurotomy (RON) is a potential therapeutic option for acute visual field deterioration.
• Optic disc drusen require careful differential diagnosis and monitoring.