Optic Nerve Drusen Evaluation: A Comparison between Ultrasound and OCT

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Techniques

Background:

• Optic disc drusen (ODD) are calcified deposits within the optic nerve head.
• Accurate detection of ODD is crucial for differential diagnosis with other optic neuropathies.
• Ultrasound (US) is a common method for ODD detection.

Purpose of the Study:

• To compare the efficacy of spectral-domain optical coherence tomography (OCT) versus B-scan ultrasound in detecting optic disc drusen.
• To evaluate OCT's ability to identify ODD and peripapillary hyperreflective ovoid mass structures (PHOMS).

Main Methods:

• Observational study involving 50 patients with ODD and 27 patients with papilledema.
• Patients diagnosed with ODD via ultrasound underwent spectral-domain OCT evaluation.
• Comparison of detection rates between US and OCT for ODD and PHOMS.

Main Results:

• OCT detected ODD and/or PHOMS in 69 out of 86 affected eyes (80.23%).
• Specific findings included ODD alone (8.14%), PHOMS alone (29.07%), and both ODD and PHOMS (43.02%).
• OCT missed ODD in 19.77% of cases and showed lower detection rates than US, particularly for buried ODD.

Conclusions:

• Spectral-domain OCT is valuable for detecting ODD and associated structures but is not a definitive standalone diagnostic tool.
• OCT's sensitivity is limited, especially for deeply located or buried optic disc drusen.
• Ultrasound remains essential for comprehensive ODD diagnosis, with OCT serving as a complementary imaging modality.