PMID- 38288170
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240131
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 12
DP  - 2023 Dec
TI  - Visual Field Defects in Patients With Optic Nerve Head Drusen.
PG  - e51317
LID - 10.7759/cureus.51317 [doi]
LID - e51317
AB  - Background Optic nerve head drusen (ONHD) are acellular deposits in the optic 
      nerve head, whose pathophysiology remains not fully understood. Most patients 
      with ONHD have visual field (VF) defects. This study aims to describe the VF 
      defects observed in patients with ONHD and to compare the anatomical and 
      functional impairment between visible and buried ONHD. Methods Patients with ONHD 
      were retrospectively studied. The retinal nerve fiber layer (RNFL) average 
      thickness and the ganglion cell complex (GCC) average thickness were collected 
      from optical coherence tomography data. Visual field index (VFI), mean deviation 
      (MD), and pattern standard deviation (PSD) were collected from 30-2 standard 
      automated perimetry. An abnormal VF test was defined as having a Glaucoma 
      Hemifield Test outside normal limits and/or a PSD with a p-value<5%. Eyes with 
      superficial or buried ONHD based on visibility by slit-lamp ophthalmoscopy were 
      compared. Results Sixty-six eyes of 36 patients were included in the study. The 
      mean age was 39.6 +/- 2.5 years. Forty-nine eyes (81.7%) presented a VF defect: 
      concentric VF constriction in 19 (38.8%), arcuate scotoma in 16 (32.7%), enlarged 
      blind spot in 9 (18.4%), unspecific VF defect in 8 (16.3%), and nasal step in 3 
      (6.1%). Thirty-four eyes (51.5%) had superficial ONHD and 32 eyes (48.5%) had 
      buried ONHD. Patients with superficial ONHD were significantly older (p<0.001) 
      and presented a significantly lower VFI (p=0.010), lower MD (p=0.002), higher PSD 
      (p<0.001), thinner GCC (p<0.001), and thinner RNFL (p<0.001) than patients with 
      buried ONHD. VF defects were present in 90.6% of eyes with superficial ONHD and 
      71.4% of eyes with buried ONHD (p=0.113). The type of VF defects differed between 
      groups (p=0.020). Conclusions Functional and structural impairment is more 
      evident in eyes with superficial ONHD, maybe because the presence of 
      calcification leads to greater axonal damage. Buried ONHD is more prevalent in 
      younger patients, progressing to a superficial location and becoming calcified 
      with age.
CI  - Copyright (c) 2023, Viana et al.
FAU - Viana, Ana Rita
AU  - Viana AR
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
FAU - Pereira, Sara
AU  - Pereira S
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
FAU - Lemos, Alberto
AU  - Lemos A
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
FAU - Basto, Rita
AU  - Basto R
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
FAU - Correia Barbosa, Renato
AU  - Correia Barbosa R
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
FAU - Reis da Silva, Alexandre
AU  - Reis da Silva A
AD  - Ophthalmology Department, Hospital Pedro Hispano, Unidade Local de Saude de 
      Matosinhos, Matosinhos, PRT.
LA  - eng
PT  - Journal Article
DEP - 20231230
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10823312
OTO - NOTNLM
OT  - anatomical impairment
OT  - automated perimetry
OT  - functional impairment
OT  - optic nerve head drusen
OT  - optical coherence tomography
OT  - visual field
COIS- The authors have declared that no competing interests exist.
EDAT- 2024/01/30 06:42
MHDA- 2024/01/30 06:43
PMCR- 2023/12/30
CRDT- 2024/01/30 03:39
PHST- 2023/12/29 00:00 [accepted]
PHST- 2024/01/30 06:43 [medline]
PHST- 2024/01/30 06:42 [pubmed]
PHST- 2024/01/30 03:39 [entrez]
PHST- 2023/12/30 00:00 [pmc-release]
AID - 10.7759/cureus.51317 [doi]
PST - epublish
SO  - Cureus. 2023 Dec 30;15(12):e51317. doi: 10.7759/cureus.51317. eCollection 2023 
      Dec.