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Observational Study
. 2020 Sep;34(9):1577-1584.
doi: 10.1038/s41433-019-0694-6. Epub 2019 Nov 19.

Optic disc drusen in children: morphologic features using EDI-OCT

Filipa Jorge Teixeira  1   2 , Raquel Esteves Marques  3   4 , Sofia Sousa Mano  3   4 , Rita Couceiro  5 , Filomena Pinto  3   4
Affiliations
Observational Study

Optic disc drusen in children: morphologic features using EDI-OCT

Filipa Jorge Teixeira et al. Eye (Lond). 2020 Sep.

Abstract

Aims: This study aimed to investigate morphologic features of optic disc drusen (ODD) and peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children, using enhanced depth imaging optical coherence tomography (EDI-OCT). It also assessed if the presence of these features were associated with decreased peripapillary retinal nerve fibre layer (RNFL) thickness.

Methods: Retrospective observational study of children with ODD. All subjects underwent complete ophthalmic examination and multimodal imaging. ODD were identified on EDI-OCT as circumscribed hyporeflective spheroidal elements located in front of lamina cribrosa, fully or partially surrounded by a hyperreflective border. PHOMS were identified as hyperreflective ovoid structures located in the peripapillary circumference. Both associations between ODD and RNFL loss and PHOMS and RNFL loss were tested using chi-squared test.

Results: In total, 38 eyes of 20 children were analysed. PHOMS were present in 90% of patients. ODD and PHOMS were predominantly found in the nasal, superonasal and inferonasal sectors. A significant positive association was found between ODD and decreased RNFL thickness in the nasal (p = 0.02), superonasal (p = 0.05) and inferotemporal (p = 0.04) sectors. There was no significant association found with the presence of PHOMS.

Conclusion: EDI-OCT allowed morphological analysis of ODD and PHOMS in children. Drusen were found to be distinct from PHOMS both in their appearance and impact on the RNFL. ODD are hyporeflective and appear on the ONH above the lamina cribrosa and were associated with decreased thickness of the RNFL. On the contrary, PHOMS are hyperreflective structures located around the ONH and were not associated with RNFL loss.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Configuration of optic disc drusen (left) and PHOMS (right) on EDI-OCT. On the left ODD appear as large ovoid regions of lower reflectivity (arrowheads), with hyperreflective margins. Please note hyperreflective horizontal lines in deep location of the scleral canal (arrows). On the right PHOMS present as hyperreflective ovoid masses (arrowheads) around ONH. Abbreviations: EDI-OCT enhanced depth imaging optical coherence tomography, ODD optic disc drusen, PHOMS peripapillary hyperreflective ovoid mass-like structures
Fig. 2
Fig. 2
Sector representation of the detection of ODD and PHOMS with EDI-OCT (first row). Co-occurrence of ODD/PHOMS and same sector thinning of RNFL (second row). A grey shade is present in the sectors were a statistically significant (p ≤ 0.05) association was found between the presence of ODD and decreased RNFL thickness. Abbreviations: T temporal sector, TS superotemporal sector, NS superonasal sector, T temporal sector, N nasal sector, NI inferonasal sector, TI inferotemporal sector, EDI-OCT enhanced depth imaging optical coherence tomography, ODD optic disc drusen, PHOMS peripapillary hyperreflective ovoid mass-like structures, RNFL, retinal nerve fibre layer
Fig. 3
Fig. 3
Retinal nerve fibre layer (RNFL) thickness OCT diagram. Green line: general population RNFL thickness. Black middle line: mean thickness of the study population with optic disc drusen; Grey superior line: upper standard deviation thickness; Grey inferior line: lower standard deviation thickness
See this image and copyright information in PMC

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