11/43. Visual-field loss with optic nerve drusen and ocular hypertension: a case report.BACKGROUND: patients with optic nerve drusen are often asymptomatic and free of visual symptoms. However, ocular complications such as visual-field defects may develop. This article presents the case of a patient with optic nerve drusen, ocular hypertension, and a visual-field defect. The diagnosis and management of patients with such findings will be presented. CASE REPORT: A 75-year-old man came to the eye clinic with a history of being treated for glaucoma. On examination, optic nerve drusen were found in both eyes. Subsequent testing revealed ocular hypertension and a visual-field defect that could be related to either optic nerve drusen or glaucoma. After re-establishment of baseline intraocular pressures (IOP) and re-initiation of treatment, the patient is being monitored for IOP control and visual-field progression. CONCLUSION: optic nerve drusen and glaucoma can both cause visual-field defects. When a patient manifests optic nerve drusen, ocular hypertension, and visual-field defects, a diagnostic and management dilemma exists. Regardless of the etiology for the field defects, a treatment regimen designed to reduce the intraocular pressure to a level that potentially reduces the risk of ocular sequelae is recommended.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
12/43. Progressive visual failure in an eye with optic disc drusen and an orbital mass.A 44-year-old woman with progressive monocular visual loss was found to have ipsilateral optic disc drusen and an ipsilateral orbital apex mass compressing the optic nerve. The mass, not the drusen, was considered responsible for the worsening vision. Visual loss should not be glibly attributed to drusen, particularly if the visual loss is rapidly progressive. Retrobulbar imaging should be considered in such cases.- - - - - - - - - - ranking = 0.66666666666667keywords = optic (Clic here for more details about this article) |
13/43. Submacular surgery for choroidal neovascularization secondary to optic nerve drusen.PURPOSE: To report a case of bilateral choroidal neovascularization (CNV) secondary to optic nerve drusen (OND). DESIGN: Interventional case report. methods: A 9-year-old girl presented with peripapillary CNV of the right eye and peripapillary and subfoveal CNV of the left eye secondary to OND. The CNV was excised with submacular surgery in the left eye. RESULTS: visual acuity increased from 0.05 to 0.3 in the left eye after submacular surgery and did not change from 0.3 in the right eye during 6-month follow-up. Partial retinal pigment epithelial atrophy, but no recurrence of CNV, was observed after CNV excision. CONCLUSION: Subfoveal CNV is an uncommon complication of OND and surgical excision may be useful in selected cases.- - - - - - - - - - ranking = 0.55555555555556keywords = optic (Clic here for more details about this article) |
14/43. Anterior ischemic optic neuropathy in eyes with optic disc drusen.BACKGROUND: There have been anecdotal reports of anterior ischemic optic neuropathy (AION) occurring in eyes with optic disc drusen (ODD), but the clinical features of this condition have not been well characterized. OBJECTIVES: To better describe the clinical features of AION associated with ODD and to compare the clinical features of this condition with those of "garden variety" nonarteritic AION. methods: We reviewed the medical records of 20 patients who experienced an episode of AION in an eye with ODD. In 4 patients, both eyes were affected; thus, 24 eyes were studied. The diagnosis of ODD was made by ophthalmoscopic identification, orbital ultrasonography, or computed tomographic scanning. We recorded age, sex, vascular risk factors, symptoms, visual acuity, visual fields, and results of the follow-up examination in all patients. These findings were compared with data from previously reported series of patients with nonarteritic AION. RESULTS: Our 20 patients included 14 men and 6 women (age range, 18-69 years; mean, 49.4 years). Vascular risk factors were identified in 10 patients (50%). Three patients reported episodes of transient visual loss before their fixed deficit. The visual acuity at the initial examination was 20/60 or better in 15 (62%) of the 24 eyes; 8 had a visual acuity of 20/20. The predominant pattern of visual field loss was an altitudinal or arcuate defect in 19 (79%) and a centrocecal scotoma in 5 (21%) of the 24 eyes. There was subjective worsening of vision before the initial neuro-ophthalmic examination in 11 eyes (46%) and objective documentation of progression in 7 eyes (29%). The final visual acuity was 20/40 or better in 13 (62%) of 21 eyes and 20/200 or worse in 3 (14%) of 21 eyes. CONCLUSIONS: Our patients were strikingly similar to those with nonarteritic AION unassociated with drusen in regard to prevalence of vascular risk factors, pattern of visual field loss, and occurrence of a subsequent similar event in the fellow eye. In contrast, however, patients with ODD-AION were younger than those with nonarteritic AION, were more likely to report preceding episodes of transient visual obscuration, and enjoyed a more favorable visual outcome.- - - - - - - - - - ranking = 1.1111111111111keywords = optic (Clic here for more details about this article) |
15/43. Laser photocoagulation for choroidal neovascular membrane associated with optic disc drusen.PURPOSE: To report two cases of choroidal neovascular membrane associated with optic disc drusen which were successfully treated using argon laser photocoagulation. methods: Choroidal neovascular complications of optic disc drusen were diagnosed in two of our patients, a 36-year-old woman and a 14-year-old girl. In both cases visual acuity was 20/100 in the affected eye. Fundus examination and angiography revealed a choroidal neovascular membrane. Computer tomography identified bilateral calcified drusen of the optic discs. Photocoagulation of neovascular tissues was immediately performed. RESULTS: visual acuity improved progressively, reaching 20/20 10 months after treatment in one case and 20/30 in the other. No recurrence was observed during follow-up. CONCLUSION: early diagnosis and immediate laser photocoagulation of vision-threatening choroidal neovascular membranes associated with optic disc drusen helps stop progression towards the macula and improves longterm visual acuity.- - - - - - - - - - ranking = 0.88888888888889keywords = optic (Clic here for more details about this article) |
16/43. Surgical removal of peripapillary choroidal neovascularization associated with optic nerve drusen.PURPOSE: To assess the anatomical and functional results after surgical removal of peripapillary choroidal neovascularization (CNV) associated with optic nerve head drusen. methods: A retrospective study was carried out on four eyes (four patients) undergoing vitrectomy, retinotomy, and removal of CNV associated with optic disk drusen. CNV was preoperatively demonstrated by fluorescein angiography in all cases. In three cases, the CNV had a subfoveal extension, and a serous-hemorrhagic retinal detachment was the cause of the central vision disturbance in the remaining one. optic nerve head drusen were bilateral and were confirmed with computed tomography scan. RESULTS: visual acuity (VA) improved in all cases after a follow-up ranging from 12 to 42 months. Preoperative VA was 20/200, 20/200, 20/50, and count fingers and final VA was 20/50, 20/25, 20/25, and 20/30, respectively. There was no evidence of CNV recurrence during the follow-up period. CONCLUSION: The results of surgical removal of peripapillary CNV with macular involvement associated with optic nerve head drusen are very encouraging, especially if we consider the variable outcome of the natural course in these cases.- - - - - - - - - - ranking = 0.91183926542642keywords = optic disk, optic, disk (Clic here for more details about this article) |
17/43. Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin.PURPOSE: To report a case of bilateral choroidal neovascularization (CNV) associated with optic nerve drusen (OND) treated with photodynamic therapy (PDT) with verteporfin. methods: A 10-year-old girl with juxtapapillary CNV in the right eye and juxtapapillary and juxtafoveal CNV in the left eye associated with OND underwent PDT with verteporfin in both eyes. RESULTS: visual acuity increased from 20/160 to 20/25 in the right eye and from 20/1000 to 20/25 in the left eye after two sessions of PDT and 2 years of follow-up. CNV showed no leakage after two PDT sessions in both eyes and no recurrence was observed. CONCLUSIONS: Subfoveal CNV is an uncommon complication of OND and excellent anatomic and functional results can be obtained with PDT.- - - - - - - - - - ranking = 0.55555555555556keywords = optic (Clic here for more details about this article) |
18/43. Limitations of color Doppler sonography in the imaging of ocular vessels.PURPOSE: To describe a case where detection of blood flow in the central retinal artery and the central retinal vein was limited by an artifact evoked by the optic disc drusen. methods Case report. RESULTS: During color Doppler sonography, examination of optic disc drusen may generate an artifact--the so-called twinkling artifact--which can simulate blood flow and make evaluation of the central retinal vessels impossible. CONCLUSIONS: Twinkling artifact does not allow evaluation of color Doppler sonography in the imaging of ocular vessels.- - - - - - - - - - ranking = 0.22222222222222keywords = optic (Clic here for more details about this article) |
19/43. Progression from anomalous optic discs to visible optic disc drusen.At age 5, a patient underwent fundus photography that disclosed elevated optic discs without drusen. A head computed tomography did not show optic nerve calcification. At age 9, no disc drusen were evident by ophthalmoscopy, but a CT now showed optic nerve calcification. At age 12, optic disc drusen were faintly evident on photographs; visual fields showed blind spot enlargement OD and an arcuate defect OS. At age 21, he had numerous discrete disc drusen in both eyes, disc pallor, and slight progression of the visual field defects. This case documents the progression from anomalous optic discs to ophthalmoscopically visible optic nerve drusen over a 16-year period.- - - - - - - - - - ranking = 1.5555555555556keywords = optic (Clic here for more details about this article) |
20/43. Photodynamic therapy for choroidal neovascular membrane secondary to optic nerve drusen.The authors describe the use of photodynamic therapy with verteporfin for subfoveal choroidal neovascular membrane secondary to optic nerve drusen. A 28-year-old woman had a peripapillary choroidal neovascular membrane secondary to optic nerve drusen with significant metamorphopsia. Photodynamic therapy using verteporfin was performed. visual acuity improved to 20/20 with resolution of metamorphopsia and absence of leakage on fluorescein angiography a few weeks after verteporfin therapy. The patient's condition remained stable for 16 months with 20/20 vision. Photodynamic therapy with verteporfin may be a useful treatment option in patients with choroidal neovascular membranes secondary to optic nerve drusen.- - - - - - - - - - ranking = 0.77777777777778keywords = optic (Clic here for more details about this article) |
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