PMID- 24064526
OWN - NLM
STAT- MEDLINE
DCOM- 20140408
LR  - 20181202
IS  - 1538-9235 (Electronic)
IS  - 1040-5488 (Linking)
VI  - 90
IP  - 10
DP  - 2013 Oct
TI  - Optic disc drusen in a child: diagnosis using noninvasive imaging tools.
PG  - e269-73
LID - 10.1097/OPX.0000000000000021 [doi]
AB  - PURPOSE: To describe a case of bilateral optic nerve head drusen (ONHD) in a 
      pediatric patient and the complementary use of advanced noninvasive imaging 
      techniques to confirm this diagnosis. CASE REPORT: A 15-year-old female 
      adolescent with type 1 diabetes and no ocular history was seen at a routine 
      screening without complaints. Visual acuity was 20/20 bilaterally, and visual 
      fields using frequency doubling technology (Zeiss Humphrey Systems, Dublin, CA) 
      were within normal limits. Fundus photography (CX-1 Mydriatic/Non-Mydriatic 
      Hybrid Digital Retinal Camera, Canon, Toyko, Japan) showed slight elevation of 
      the left disc margin, with lack of physiologic cup, elevation of the inferior 
      neuroretinal rim, and no swelling of the nerve fiber layer. Fundus 
      autofluorescence image of the left eye showed hyperfluorescence in the inferior 
      optic disc. Red/green/blue channel separation analysis using the blue channel 
      (Eye-Q software, Canon, Irvine, CA) showed elevation of the nerve fiber layer 
      without obscuration of small vessels surrounding the left optic disc. Embossed 
      technique highlighted the drusen in the left disc. B-scan ultrasound (Eye Cubed, 
      Ellex, Adelaide, Australia) showed a hyperechoic focus on the optic disc with 
      posterior shadowing and corresponding spike on A-scan in both eyes, indicative of 
      bilateral drusen. Optical coherence tomography (RTVue, Optovue, Fremont, CA) 
      showed an elevation in the ONH corresponding to the drusen. CONCLUSIONS: The 
      complementary use of noninvasive imaging modalities such as fundus 
      autofluorescence, red/green/blue separation, B-scan, and optical coherence 
      tomography is important in confirming the diagnosis of ONHD in pediatric 
      patients. They allow us to rule out more serious conditions and avoid 
      unnecessary, costly, and invasive investigative procedures, relieving young 
      patients and their families of potential financial and emotional burdens.
FAU - Shah, Avni
AU  - Shah A
AD  - *MD daggerPhD Institute of Ophthalmology and Visual Science, Rutgers-New Jersey 
      Medical School, Newark, New Jersey.
FAU - Szirth, Bernard
AU  - Szirth B
FAU - Sheng, Iris
AU  - Sheng I
FAU - Xia, Tina
AU  - Xia T
FAU - Khouri, Albert S
AU  - Khouri AS
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Optom Vis Sci
JT  - Optometry and vision science : official publication of the American Academy of 
      Optometry
JID - 8904931
SB  - IM
MH  - Adolescent
MH  - Female
MH  - *Fluorescein Angiography
MH  - Fundus Oculi
MH  - Humans
MH  - Optic Disk/*pathology
MH  - Optic Disk Drusen/*diagnosis
MH  - Tomography, Optical Coherence/*methods
MH  - Visual Acuity/physiology
MH  - Visual Fields/physiology
EDAT- 2013/09/26 06:00
MHDA- 2014/04/09 06:00
CRDT- 2013/09/26 06:00
PHST- 2013/09/26 06:00 [entrez]
PHST- 2013/09/26 06:00 [pubmed]
PHST- 2014/04/09 06:00 [medline]
AID - 00006324-201310000-00023 [pii]
AID - 10.1097/OPX.0000000000000021 [doi]
PST - ppublish
SO  - Optom Vis Sci. 2013 Oct;90(10):e269-73. doi: 10.1097/OPX.0000000000000021.