V Pipelart1, B Leroux2, S Leruez2, S Henni3, N Navasiolava4, L Martin5, J-M Ebran6. 1. Department of Ophthalmology, Angers University Hospital, 2, rue Larrey, 49933 Angers cedex 9, France. Electronic address: valentinpipelart@yahoo.fr. 2. Department of Ophthalmology, Angers University Hospital, 2, rue Larrey, 49933 Angers cedex 9, France. 3. Department of Vascular Function Investigation, Angers University Hospital, 49933 Angers, France; Pseudoxanthoma Elasticum Referral Centre, Angers University Hospital, 49933 Angers, France. 4. Pseudoxanthoma Elasticum Referral Centre, Angers University Hospital, 49933 Angers, France. 5. Pseudoxanthoma Elasticum Referral Centre, Angers University Hospital, 49933 Angers, France; Department of Dermatology, Angers University Hospital, 49933 Angers, France. 6. Department of Ophthalmology, Angers University Hospital, 2, rue Larrey, 49933 Angers cedex 9, France; Pseudoxanthoma Elasticum Referral Centre, Angers University Hospital, 49933 Angers, France.
Abstract
PURPOSE: To investigate the prevalence and location of optic nerve head drusen and their potential association with other PXE-related ophthalmic abnormalities. MATERIALS AND METHODS: Thirty-eight of the 155 patients (57 male and 98 female aged 49±17 years) included in this retrospective study had optic nerve head drusen. All of the patients underwent a comprehensive ophthalmic examination, including color images using red-free, blue and red filters, autofluorescence imaging and late-phase ICG frames. Comparative analysis of both groups (optic nerve head drusen or not) was conducted using R statistical software. RESULTS: The prevalence of optic nerve head drusen in our cohort was 24.5%. In this study, no evidence of a significant link between optic nerve head drusen and other fundus abnormalities was detected. They were more commonly located in the nasal sector than in the temporal sector of the optic disc (P<0.001). They were more frequently situated superonasally than inferonasally (P<0.004), superotemporally (P<0.001) or inferotemporally (P<0.03). No central visual field defect was observed in OND+ patients who were unaffected by macular disorders. DISCUSSION: We hypothesized this predominantly nasal primary location may result from greater sensitivity in the nasal optic nerve fibers which follow a much more angular path once they arrive in the scleral canal, accounting for accumulation of axoplasmic debris. CONCLUSION: In PXE, optic nerve head drusen are mostly located in the superonasal quadrant, causing progressive optic nerve invasion but probably no central visual field defects.
PURPOSE: To investigate the prevalence and location of optic nerve head drusen and their potential association with other PXE-related ophthalmic abnormalities. MATERIALS AND METHODS: Thirty-eight of the 155 patients (57 male and 98 female aged 49±17 years) included in this retrospective study had optic nerve head drusen. All of the patients underwent a comprehensive ophthalmic examination, including color images using red-free, blue and red filters, autofluorescence imaging and late-phase ICG frames. Comparative analysis of both groups (optic nerve head drusen or not) was conducted using R statistical software. RESULTS: The prevalence of optic nerve head drusen in our cohort was 24.5%. In this study, no evidence of a significant link between optic nerve head drusen and other fundus abnormalities was detected. They were more commonly located in the nasal sector than in the temporal sector of the optic disc (P<0.001). They were more frequently situated superonasally than inferonasally (P<0.004), superotemporally (P<0.001) or inferotemporally (P<0.03). No central visual field defect was observed in OND+ patients who were unaffected by macular disorders. DISCUSSION: We hypothesized this predominantly nasal primary location may result from greater sensitivity in the nasal optic nerve fibers which follow a much more angular path once they arrive in the scleral canal, accounting for accumulation of axoplasmic debris. CONCLUSION: In PXE, optic nerve head drusen are mostly located in the superonasal quadrant, causing progressive optic nerve invasion but probably no central visual field defects.
Authors: Kristina Hess; Martin Gliem; Peter Charbel Issa; Johannes Birtel; Philipp L Müller; Leon von der Emde; Philipp Herrmann; Frank G Holz; Maximilian Pfau Journal: JAMA Ophthalmol Date: 2020-12-01 Impact factor: 7.389