A retrospective case notes review is presented focusing on children diagnosed with optic nerve head drusen over an eight-year period. Inclusion criteria included cases coded for optic nerve head drusen and / or pseudopapilledema. The aim of the study was to characterise the visual morbidity which is associated with optic nerve head drusen specifically in a paediatric population. A total of 213 patients (386 eyes) met the criteria for inclusion. The majority of cases were diagnosed using a B-scan (93%) at a mean age of 10.1 years old. The patterns of visual field defect were most commonly a nasal step (46%), accurate (29%) and enlarged blind spot (14%). These results are only from the 11.5% of perimetry assessments that were classified as repeatable. The visual field defects identified at diagnosis remained stable, however for those that developed during follow-up the majority continued to progress. No correlation was found between mean deviation of visual field and intraocular pressure. The authors suggest that perimetry could be used as a biomarker for disease progression in children diagnosed with optic nerve head drusen in the future if treatment options become available. Further research is required to identify possible risk factors for those children that develop progressive visual field loss.
Natural history of optic nerve head drusen in a paediatric population
Reviewed by Lauren Hepworth
The visual morbidity of optic nerve head drusen: a longitudinal review.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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