Optic disc drusen are small, calcifying deposits of protein and calcium in the optic nerve head (optic disc). They occur in about 1 to 2 % of the population, usually affect both eyes and are frequently discovered as an incidental finding during a routine examination. In most cases optic disc drusen are harmless and require no treatment.
Optic disc drusen form slowly over years, probably from metabolic products of the optic nerve fibres, which are deposited at the optic nerve head and calcify. The exact cause has not been fully established. Since drusen occur more often within families, an inherited predisposition is assumed.
Most of those affected notice nothing: optic disc drusen generally cause no complaints. In some cases, however, the following changes can occur:
The main issue is that optic disc drusen can make the optic nerve head appear enlarged and swollen. This picture resembles papilloedema, a genuine swelling of the optic nerve, which can indicate raised intracranial pressure. Telling the two apart correctly is therefore crucial in order to avoid unnecessary and stressful investigations.
Whether an unusual optic nerve head is caused by drusen or by real swelling can be distinguished in a targeted eye examination. Dr. Stefan Langenegger assesses the findings, plans the follow-up checks and, on request, also examines parents, siblings or children, just a few steps from Zurich main station.
Superficial drusen are often directly visible on ophthalmoscopy as yellowish, glistening, irregular elevations on the disc. Deeper (buried) drusen require additional investigations:
Since optic disc drusen can be inherited, it is advisable, once the diagnosis is made, to have family members (parents, siblings, children) examined by an ophthalmologist as well.
There is no treatment for optic disc drusen themselves, and in the great majority of cases none is needed. If rare complications such as choroidal neovascularisation occur, these can be treated with laser or injections of medication.
Regular ophthalmological check-ups are recommended in order to:
Most patients with optic disc drusen retain good vision and need no more than annual check-ups. Despite the unusual name, the prognosis is generally very favourable.
