Hemorrhagic complications of optic nerve drusen

We found hemorrhages in 13 eyes of 57 patients with optic disk drusen. In seven eyes, the hemorrhages originated in peripapillary choroidal neovascular membranes. In the other six eyes, no neovascular membrane was present. Hemorrhages that occurred in the absence of choroidal new vessels caused no visual symptoms in any patient. All resolved without sequelae. Hemorrhages originating in choroidal neovascular membranes commonly caused visual symptoms; however, six of seven eyes retained visual acuities of 6/12 (20/40) or better without any therapy. Thus, despite potential submacular hemorrhage, we do not recommend routine photocoagulation for peripapillary choroidal neovascular membranes secondary to optic disk drusen.