POOR VISUAL OUTCOMES IN SYPHILITIC UVEITIS ASSOCIATED WITH METHAMPHETAMINE USE: A CASE SERIES.
Article
Overview
abstract
Optic nerve drusen are refractive, calcified nodules located within the optic disc, the most anterior part of the optic nerve. The optic disc is visible in the retina on indirect fundoscopy. Anatomically, optic nerve drusen are located just anterior to the lamina cribrosa and are most commonly seen in the nasal part of the disc. These largely acellular calcifications, usually detected incidentally on an exam, may progress and become more visible during earlier decades of life but rarely change significantly over a patient's lifetime and are generally asymptomatic. Although most are asymptomatic, optic nerve drusen have been associated with visual field defects, anterior ischemic optic neuropathy, transient visual obscurations, and more rare complications. Superficial drusen can be diagnosed clinically; however, deeper or buried drusen may give the appearance of a swollen disc or edema (i.e., papilledema or bilateral disc swelling secondary to increased intracranial pressure) and require further evaluation and testing to confirm the diagnosis. Despite their different locations, superficial and deep drusen represent the same pathology. While drusen may give the appearance of disc edema or swelling, or pseudo papilledema, the presence of drusen does not exclude the presence of actual edema. For example, there is a high prevalence of nerve drusen in young patients with idiopathic intracranial hypertension. Although no pattern of inheritance has been fully elucidated, autosomal dominant inherence with incomplete penetrance is the leading suspicion.
