Steffen Hamann1, Lasse Malmqvist2, Marianne Wegener2, Valérie Biousse3, Lulu Bursztyn4, Gülsenay Citirak2, Fiona Costello5, Alison V Crum6, Kathleen Digre6, Masoud Aghsaei Fard7, J Alexander Fraser8, Ruth Huna-Baron9, Bradley Katz6, Mitchell Lawlor10, Nancy J Newman3, Jason H Peragallo3, Axel Petzold11, Patrick A Sibony12, Prem S Subramanian13, Judith Ea Warner6, Sui H Wong14, Clare L Fraser10. 1. Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: steffen.hamann@regionh.dk. 2. Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Denmark. 3. Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta, USA. 4. Department of Ophthalmology, Western University, Canada. 5. Departments of Clinical Neurosciences and Surgery, University of Calgary, Canada. 6. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, Department of Neurology, University of Utah, USA. 7. Farabi Eye Hospital, Tehran University of Medical Science, Iran. 8. Department of Ophthalmology, Western University, Canada; Department of Clinical Neurological Sciences, Western University, Canada. 9. Goldschleger Eye Institute, Sheba Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel. 10. Save Sight Institute, Faculty of Health and Medicine, The University of Sydney, Australia. 11. Moorfields Eye Hospital, The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology UCL; Neuro-ophthalmology Expertise Centre, Amsterdam UMC (locatie VUmc), The Netherlands. 12. Department of Ophthalmology, State University of New York at Stony Brook, USA. 13. Departments of Ophthalmology, Neurology, and Neurosurgery, Sue Anschutz-Rodgers UCHealth Eye Center, University of Colorado School of Medicine, USA. 14. Department of Neuro-ophthalmology, Moorfields Eye Hospital, United Kingdom.
Abstract
PURPOSE: Optic disc drusen (ODD), present in 2% of the general population, have occasionally been reported in patients with non-arteritic anterior ischemic optic neuropathy (NA-AION). The purpose of this study was to examine the prevalence of ODD in young patients with NA-AION. DESIGN: retrospective, cross-sectional multicenter study. METHODS: All patients with NA-AION age 50 years or less, seen in neuro-ophthalmology clinics of the international ODDS (Optic Disc Drusen Studies) Consortium between April 1, 2017, and March 31, 2019, were identified. Patients were included if ODD were diagnosed by any method, or if ODD were excluded by enhanced-depth imaging optical coherence tomography (EDI-OCT) using the ODDS Consortium guidelines. NA-AION eyes with ODD were termed "ODD-AION"; those without were termed "NODD-AION". RESULTS: Sixty-five patients (127 eyes) with NA-AION were included (mean age 41 years). Of the 74 eyes with NA-AION, 51% had ODD (ODD-AION), while 43% of (fellow) eyes without NA-AION had ODD (P=0.36). No significant difference was found between ODD-AION and NODD-AION eyes in terms of Snellen BCVA or perimetric mean deviation. On EDI-OCT, 28% of eyes with NODD-AION had peripapillary hyperreflective ovoid mass-like structures (PHOMS) and 7% had hyperreflective lines while 54% with ODD-AION had PHOMS and 66% had hyperreflective lines (P=0.006 and P<0.001, respectively). CONCLUSIONS: The majority of our young NA-AION patients had ODD. This indicates that ODD may be an independent risk factor for the development of NA-AION, at least in younger patients. We suggest ODD-AION be recognized as a novel diagnosis.
PURPOSE: Optic disc drusen (ODD), present in 2% of the general population, have occasionally been reported in patients with non-arteritic anterior ischemic optic neuropathy (NA-AION). The purpose of this study was to examine the prevalence of ODD in young patients with NA-AION. DESIGN: retrospective, cross-sectional multicenter study. METHODS: All patients with NA-AION age 50 years or less, seen in neuro-ophthalmology clinics of the international ODDS (Optic Disc Drusen Studies) Consortium between April 1, 2017, and March 31, 2019, were identified. Patients were included if ODD were diagnosed by any method, or if ODD were excluded by enhanced-depth imaging optical coherence tomography (EDI-OCT) using the ODDS Consortium guidelines. NA-AION eyes with ODD were termed "ODD-AION"; those without were termed "NODD-AION". RESULTS: Sixty-five patients (127 eyes) with NA-AION were included (mean age 41 years). Of the 74 eyes with NA-AION, 51% had ODD (ODD-AION), while 43% of (fellow) eyes without NA-AION had ODD (P=0.36). No significant difference was found between ODD-AION and NODD-AION eyes in terms of Snellen BCVA or perimetric mean deviation. On EDI-OCT, 28% of eyes with NODD-AION had peripapillary hyperreflective ovoid mass-like structures (PHOMS) and 7% had hyperreflective lines while 54% with ODD-AION had PHOMS and 66% had hyperreflective lines (P=0.006 and P<0.001, respectively). CONCLUSIONS: The majority of our young NA-AION patients had ODD. This indicates that ODD may be an independent risk factor for the development of NA-AION, at least in younger patients. We suggest ODD-AION be recognized as a novel diagnosis.
Authors: Jonathan A Gernert; Rebecca Wicklein; Benjamin Knier; Joachim Havla; Bernhard Hemmer; Tania Kümpfel Journal: J Neurol Date: 2022-10-16 Impact factor: 6.682