Optic Disc Drusen Is Frequently Not Reported on Computed Tomography Scans Performed for Other Reasons

Optic disc drusen (ODD), which can mimic papilledema and pose a diagnostic challenge to ophthalmologists, can be effectively detected using computed tomography (CT). In this retrospective study, we investigated how often radiologists report the presence of drusen on CT scans when the indication may not have been ODD.

This was a retrospective chart review of consecutive patients with ODD with previous brain CT scan performed for various unrelated reasons. The inclusion criteria included patients with fundus autofluorescence, or optical coherence tomography-enhanced depth imaging-proven ODD who already had CT scan done for any reason.

Twenty-five CT scan reports from 23 patients (43 eyes; 17 women, 6 men) were included, with a mean age of 37.0 ± 19.2 years (range, 10-74). ODD were bilateral in 20 patients (87.0%) and unilateral in 3 (13.0%). Five CT scans were performed with contrast (20.0%) and 20 without contrast (80.0%). ODD were explicitly mentioned in only 8 of 25 reports (32.0%), despite being present in all patients. It was mentioned in all 5 scans performed for unrelated neuro-ophthalmic indications.

In conclusion, ODD were underreported on CT scans, with only 32% of reports explicitly mentioning their presence. This has implications for radiologists, who should be aware of the importance of ODD to ophthalmologists, who may look back at previous CT scans. Ophthalmologists should be aware that the absence of an ODD mention in a CT report does not indicate the absence of ODD on the imaging.