Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009 Jun-Jul;18(5):373-8.
doi: 10.1097/IJG.0b013e31818624a4.

Imaging of optic nerve head drusen: improvements with spectral domain optical coherence tomography

Kayoung Yi  1 , Mircea Mujat, Wei Sun, Daina Burnes, Mark A Latina, Derrick T Lin, Daniel G Deschler, Peter A D Rubin, Boris Hyle Park, Johannes F de Boer, Teresa C Chen
Affiliations
Comparative Study

Imaging of optic nerve head drusen: improvements with spectral domain optical coherence tomography

Kayoung Yi et al. J Glaucoma. 2009 Jun-Jul.

Abstract

Objective: To demonstrate a new algorithm that can determine the shape, location, and volume of optic nerve head drusen (ONHD), which were imaged with spectral domain optical coherence tomography (SDOCT).

Methods: One exenteration patient and 4 glaucoma patients with bilateral ONHD were recruited from the Massachusetts Eye and Ear Infirmary and from a private practice office. Images were obtained using an experimental SDOCT system developed at the Wellman Center for Photomedicine, Massachusetts General Hospital. With axial resolutions of about 6 mum, SDOCT can obtain 2-dimensional images in 1/29 of a second, compared with commercially available time domain OCT instruments with 10 mum resolution images in 1.28 seconds. The volumes of ONHD were calculated with a new algorithm and were then correlated with visual field mean deviation.

Results: SDOCT can display 2-dimensional images comparable with histology and 3-dimensional videos of ONHD. ONHD are signal-poor regions with high-signaled borders. Larger ONHD volumes are directly correlated with larger mean deviation absolute values on Humphrey visual field testing.

Conclusions: SDOCT is a potentially better technique for ONHD imaging and may improve the diagnosis and management of patients with both OHND and glaucoma.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The basic set-up of a spectral domain optical coherence tomography system. The light from the light source is split to go to a reference mirror and to the retina. As the light comes back from the mirror and the eye, it creates an interference pattern, which is analyzed by a spectrometer, and an image is created. SLD=superluminescent diode, Ti=titanium.
Figure 2
Figure 2
Results of testing OD for a patient (Case A) with optic nerve head drusen (ONHD). A: Fundus photo OD. Prominent ONHD are seen at the superior nasal border of the optic nerve head OD. B: StratusOCT3 (Stratus Optical Coherence Tomography 3; Carl Zeiss Meditec, Dublin, CA). The StratusOCT scan OD shows an elevated optic nerve head with a signal poor region below the surface.
Figure 3
Figure 3
Histology (magnification X 50, Toluidine blue staining) of a patient with optic nerve head drusen (ONHD, Case A, right eye). Multilobulated large ONHD (asterisk) and small ONHD (arrows) above the lamina cribrosa are seen on the nasal side of the optic nerve head. There is an artifactual retinal detachment, and most of the calcific substance was lost during tissue processing.
Figure 4
Figure 4
A: Spectral domain optical coherence tomography (SDOCT) image (Figure 4 A) of a patient with optic nerve head drusen (ONHD) OD (Case A) and 3-dimensional reconstruction of SDOCT images (Figure 4 B, C). The SDOCT image shows signal-poor regions (asterisks) with relatively high-signaled borders of presumed drusen (arrows). Near the surface of the optic nerve head, large circular structures are visible, which were seen to continue through serial images, and are probable blood vessels (arrowheads). B: The retinal surface viewed superiorly. Through the transparent surface, ONHD (blue) are clearly seen at the nasal aspect of the optic nerve head. C: View from the level of the retinal surface shows the spatial relationship between the optic disc and ONHD (blue). The light source was a superluminescent diode laser which achieved an axial resolution of 6 μm.
Figure 5
Figure 5
Data from Cases B through E who are patients with optic nerve head drusen and glaucoma OU. Fundus photography (first column), Humphrey visual field testing 24-2 (second column), spectral domain optical coherence tomography (SDOCT) images of drusen (blue) when viewed at the level of the retinal surface (third column) and superiorly through a transparent surface (fourth column). The light source of the SDOCT machine was a superluminescent diode laser which achieved an axial resolution of 6 μm.
Figure 6
Figure 6
Correlation between the volume (mm3) of the optic nerve head drusen (ONHD) and the magnitude (dB) of the mean deviation (MD) from Humphrey visual field testing. Excellent correlation is seen with linear regression analysis (r2=0.97). The larger the volume of the ONHD, the larger the visual field defect (as expressed as the MD).
See this image and copyright information in PMC

References

    1. Tso MOM. Pathology and Pathogenesis of Drusen of the Optic Nervehead. Opthalmology. 1981;88(10):1066–1080. - PubMed
    1. Lee AG, Zimmerman MB. The Rate of Visual Field Loss in Optic Nerve Head Drusen. Am J Ophthalmol. 2005;139(6):1062–1066. - PubMed
    1. Roh S, Noecker RJ, Schuman JS, Hedges TR, 3rd, Weiter JJ, Mattox C. Ophthalmology. 5. Vol. 105. 1998. Effect of Optic Nerve Head Drusen on Nerve Fiber Layer Thickness; pp. 878–885. - PMC - PubMed
    1. Wilkins JM, Pomeranz HD. Visual Manifestations of Visible and Buried Optic Disc Drusen. J Neuro-Ophthalmol. 2004;24(2):125–129. - PubMed
    1. Friedman AH, Gartner S, Modi SS. Drusen of the optic disc; A retrospective study in cadaver eyes. Br J Ophthalmol. 1975;(59):413–421. - PMC - PubMed

Publication types