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Optic disc drusen precipitating central retinal vein occlusion in young

BMJ case reports, 2019-07, Vol.12 (7), p.e230677 [Peer Reviewed Journal]

BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. ;2019 BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. ;BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. 2019 ;ISSN: 1757-790X ;EISSN: 1757-790X ;DOI: 10.1136/bcr-2019-230677 ;PMID: 31289151

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  • Title:
    Optic disc drusen precipitating central retinal vein occlusion in young
  • Author: Padhy, Srikanta Kumar ; Behera, Umesh Chandra
  • Subjects: Adolescent ; Bevacizumab - administration & dosage ; Defects ; Edema ; Fundus Oculi ; Glaucoma ; Humans ; Images In ; Injections, Intraocular ; Macular Edema - complications ; Macular Edema - diagnosis ; Macular Edema - drug therapy ; Male ; Medical imaging ; Monoclonal antibodies ; Nitric oxide ; Optic Disk Drusen - complications ; Optic Disk Drusen - diagnosis ; Optic nerve ; Optics ; Retinal Vein Occlusion - complications ; Retinal Vein Occlusion - diagnosis ; Retinal Vein Occlusion - drug therapy ; Tomography, Optical Coherence ; Ultrasonic imaging ; Ultrasonography ; Veins & arteries
  • Is Part Of: BMJ case reports, 2019-07, Vol.12 (7), p.e230677
  • Description: Optic disc drusen are calcified hyaline-like deposits in the optic nerve head concentrated anterior to the lamina cribrosa.1 It’s incidence is 0.4%–20.4% in general population with female preponderance.2 They are often bilateral (67%–91%) and are commonly found at the nasal aspect of the optic disc.2 Largely they are benign and vision sparing but rarely may complicate with visual field defects, haemorrhages, choroidal neovascularisation, serous maculopathy and non-arteritic ischaemic optic neuropathy.3–5 Enlargement of drusen with advancing age is believed to cause mechanical compression at the lamina cribrosa leading to the complications.1 Elevation of central retinal venous pressure may result in CRVO.1 2 6 The enlargement is observed mostly in teenage7 8 but to the best of our knowledge only a single case has been reported with concomitant CRVO in teenage.9 Unlike the hitherto reported case which resulted in neovascular glaucoma and retinal detachment, we achieved favourable outcome with intravitreal bevacizumab injection in the early treatment period. Universal eye screening in children could go a long way detecting optic disc drusen early and imaging modalities such as ultrasound B scan and enhanced depth optical coherence tomography can increase the sensitivity of the detection in buried drusen.10 11 Table 1 lists the reported association of optic disc drusen with CRVO in literature.Table 1 Patient demographics of the reported cases of CRVO association in eyes with optic disc drusen Author Year Age/sex CRVO severity Systemic association Treatment Brodrick12 1973 48 years/ female Optic nerve head drusen associated with extensive retinal haemorrhages Hypertension None Chern et al 13 1991 43 years/ male Non-ischaemic CRVO No systemic associations None Gallagher and Clearkin14 2000 33 years/ female Non-ischaemic CRVO On oral contraceptives None Honkanen et al 9 2011 13 years/ male Ischaemic CRVO No systemic associations Pan-retinal photocoagulation Law et al 2 2014 52 years/ male Non-ischaemic CRVO No macular involvement No systemic associations None CRVO, central retinal vein occlusion. Case report of optic disc drusen with simultaneous peripapillary subretinal hemorrhage and central retinal vein occlusion.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 1757-790X
    EISSN: 1757-790X
    DOI: 10.1136/bcr-2019-230677
    PMID: 31289151
  • Source: GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    ProQuest Central
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