Autofluorescence of Optic Nerve Drusen
- Symptoms: mostly asymptomatic, but may present with visual field defects, decreased visual acuity, or transient obscuration of vision.
- Discrete, multiple, amorphous or partly calcified hyaline bodies located anterior to the lamina cribrosa
- The bodies may be superficial or buried within the optic disc (typically in the nasal region)
- Buried hyaline bodies in children or young people may simulate papilledema
- Superficial drusen appear as autofluorescent bodies that are visible on fundus photographs using appropriate filter prior to fluorescein dye injection
- As the progression of the drusen interferes with the blood supply of the optic nerve, several conditions may result:
- Acute swelling of the optic nerve
- Splinter hemorrhage
- Ischemic optic neuropathy
- Fluoresecein angiography:
- Undilated capillary network with no leakage of dye into the peripapillary region.
- Discrete foci of hyperfluorescence with late staining of the drusen.
- B-scan ultrasound is helpful in detecting buried drusen.
- Associated ocular findings include Retinits Pigmentosa, angioid streaks in patients with or whithout pseudoxanthoma elasticum, Usher's syndrome and X-linked retinoschisis.