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Erschienen in: Spektrum der Augenheilkunde 6/2017

09.08.2017 | Angio-OCT / Medical Retina

Volume rendering of superficial optic disc drusen

A possible new imaging technique using optical coherence tomography angiography

verfasst von: Peter M. Maloca, Adnan Tufail, Catherine Egan, Sandrine Zweifel, Pascal W Hasler, Axel Petzold, J. Emanuel Ramos de Carvalho

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 6/2017

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Summary

Background

Optic disc drusen (ODD) are calcified deposits potentially caused by disturbances in axonal metabolism. The clinical course and visual impairment of ODD is usually mild; however, significant ocular morbidity may occur, such as visual field defects and retinal haemorrhages. Optic disc drusen may pose a diagnostic dilemma and differentiating these from other entities that can lead to similar compressive axonal distress is imperative. We present a novel technique for three-dimensional (3D) characterisation of superficial ODD based on 3D volume rendering of optical coherence tomography angiography (3DOCTA) scans.

Material and methods

Optical coherence tomography (Cirrus™ HD-OCT Model 5000 with AngioPlex, Carl Zeiss Meditec, Inc., Dublin, USA) scans were obtained from the optic nerve head of a healthy 22-year-old female. Consequently, 3D structural OCT data and OCTA were analysed, enabling ODD segmentation and spatial characterization.

Results

Volumetric analysis of superficial ODD showed a maximal drusen horizontal diameter of 223 μm, maximal vertical diameter of 268 μm, surface area of 6617 μm2 and volume measurement of 12,875 μm3. The drusen were characterised by a connected network of multiple drusen islands instead of forming a dense mass. Multiple vascular channels with perforating vessels were found across the drusen.

Conclusion

Three-dimensional volume rendering of OCTA scans provided new insight on the spatio-anatomical features of superficial ODD. The new features herein described, namely multilobulated drusen islands and intradrusen channels, may directly contribute to the pathogenic events leading to transient non-embolic visual loss and small vessel occlusion secondary to ODD.
Literatur
1.
Zurück zum Zitat Tso MO. Pathology and pathogenesis of drusen of the optic nervehead. Ophthalmology. 1981;88(10):1066–80.CrossRefPubMed Tso MO. Pathology and pathogenesis of drusen of the optic nervehead. Ophthalmology. 1981;88(10):1066–80.CrossRefPubMed
2.
Zurück zum Zitat Friedman AH, Henkind P, Gartner S. Drusen of the optic disc. A histopathological study. Trans Ophthalmol Soc U K. 1975;95(1):4–9.PubMed Friedman AH, Henkind P, Gartner S. Drusen of the optic disc. A histopathological study. Trans Ophthalmol Soc U K. 1975;95(1):4–9.PubMed
3.
Zurück zum Zitat Wilkins JM, Pomeranz HD. Visual manifestations of visible and buried optic disc drusen. J Neuroophthalmol. 2004;24(2):125–9.CrossRefPubMed Wilkins JM, Pomeranz HD. Visual manifestations of visible and buried optic disc drusen. J Neuroophthalmol. 2004;24(2):125–9.CrossRefPubMed
4.
Zurück zum Zitat Duncan JE, Freedman SF, El-Dairi MA. The incidence of neovascular membranes and visual field defects from optic nerve head drusen in children. J AAPOS. 2016;20(1):44–8.CrossRefPubMed Duncan JE, Freedman SF, El-Dairi MA. The incidence of neovascular membranes and visual field defects from optic nerve head drusen in children. J AAPOS. 2016;20(1):44–8.CrossRefPubMed
5.
Zurück zum Zitat Calvo-Gonzalez C, et al. Optic nerve drusen and deep visual fields defects. Arch Soc Esp Oftalmol. 2006;81(5):269–73.PubMed Calvo-Gonzalez C, et al. Optic nerve drusen and deep visual fields defects. Arch Soc Esp Oftalmol. 2006;81(5):269–73.PubMed
6.
Zurück zum Zitat Moody TA, et al. Sudden visual field constriction associated with optic disc drusen. J Clin Neuroophthalmol. 1993;13(1):8–13, discussion 14.PubMed Moody TA, et al. Sudden visual field constriction associated with optic disc drusen. J Clin Neuroophthalmol. 1993;13(1):8–13, discussion 14.PubMed
7.
Zurück zum Zitat Lee KM, Hwang JM, Woo SJ. Hemorrhagic complications of optic nerve head drusen on spectral domain optical coherence tomography. Retina (Philadelphia, Pa). 2014;34(6):1142–8.CrossRef Lee KM, Hwang JM, Woo SJ. Hemorrhagic complications of optic nerve head drusen on spectral domain optical coherence tomography. Retina (Philadelphia, Pa). 2014;34(6):1142–8.CrossRef
8.
Zurück zum Zitat Romero J, Sowka J, Shechtman D. Hemorrhagic complications of optic disc drusen and available treatment options. Optometry. 2008;79(9):496–500.CrossRefPubMed Romero J, Sowka J, Shechtman D. Hemorrhagic complications of optic disc drusen and available treatment options. Optometry. 2008;79(9):496–500.CrossRefPubMed
9.
Zurück zum Zitat Kazimierz Rubinstein KM, Ali M. Retinal complications of optic disc drusen. Br J Ophthalmol. 1982;66(2):83–95.CrossRef Kazimierz Rubinstein KM, Ali M. Retinal complications of optic disc drusen. Br J Ophthalmol. 1982;66(2):83–95.CrossRef
10.
Zurück zum Zitat Chiang J, et al. The usefulness of multimodal imaging for differentiating pseudopapilloedema and true swelling of the optic nerve head: a review and case series. Clin Exp Optom. 2015;98(1):12–24.CrossRefPubMed Chiang J, et al. The usefulness of multimodal imaging for differentiating pseudopapilloedema and true swelling of the optic nerve head: a review and case series. Clin Exp Optom. 2015;98(1):12–24.CrossRefPubMed
11.
Zurück zum Zitat Lee KM, Woo SJ, Hwang JM. Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography. Ophthalmology. 2011;118(5):971–7.CrossRefPubMed Lee KM, Woo SJ, Hwang JM. Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography. Ophthalmology. 2011;118(5):971–7.CrossRefPubMed
12.
Zurück zum Zitat Lee KM, Woo SJ, Hwang JM. Morphologic characteristics of optic nerve head drusen on spectral-domain optical coherence tomography. Am J Ophthalmol. 2013;155(6):1139–1147.e1.CrossRefPubMed Lee KM, Woo SJ, Hwang JM. Morphologic characteristics of optic nerve head drusen on spectral-domain optical coherence tomography. Am J Ophthalmol. 2013;155(6):1139–1147.e1.CrossRefPubMed
14.
Zurück zum Zitat Silverman AL, et al. Assessment of optic nerve head drusen using enhanced depth imaging and swept source optical coherence tomography. J Neuroophthalmol. 2014;34(2):198–205.CrossRefPubMedPubMedCentral Silverman AL, et al. Assessment of optic nerve head drusen using enhanced depth imaging and swept source optical coherence tomography. J Neuroophthalmol. 2014;34(2):198–205.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Slotnick S, Sherman J. Buried disc drusen have hypo-reflective appearance on SD-OCT. Optom Vis Sci. 2012;89(5):E704–E8.CrossRefPubMed Slotnick S, Sherman J. Buried disc drusen have hypo-reflective appearance on SD-OCT. Optom Vis Sci. 2012;89(5):E704–E8.CrossRefPubMed
16.
Zurück zum Zitat Sato T, Mrejen S, Spaide RF. Multimodal imaging of optic disc drusen. Am J Ophthalmol. 2013;156(2):275–282.e1.CrossRefPubMed Sato T, Mrejen S, Spaide RF. Multimodal imaging of optic disc drusen. Am J Ophthalmol. 2013;156(2):275–282.e1.CrossRefPubMed
17.
Zurück zum Zitat Chaudhry NA, et al. Photodynamic therapy for choroidal neovascular membrane secondary to optic nerve drusen. Ophthalmic Surg Lasers Imaging. 2005;36(1):70–2.PubMed Chaudhry NA, et al. Photodynamic therapy for choroidal neovascular membrane secondary to optic nerve drusen. Ophthalmic Surg Lasers Imaging. 2005;36(1):70–2.PubMed
18.
Zurück zum Zitat Delas B, et al. Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy. Clin Ophthalmol. 2012;6:225–30.CrossRefPubMedPubMedCentral Delas B, et al. Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy. Clin Ophthalmol. 2012;6:225–30.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Silva R, et al. Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin. Eur J Ophthalmol. 2004;14(5):434–7. Silva R, et al. Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin. Eur J Ophthalmol. 2004;14(5):434–7.
20.
Zurück zum Zitat Sanders TE, Gay AJ, Newman M. Hemorrhagic complications of drusen of the optic disk. Am J Ophthalmol. 1971;71(1 Pt 2):204–17.CrossRefPubMed Sanders TE, Gay AJ, Newman M. Hemorrhagic complications of drusen of the optic disk. Am J Ophthalmol. 1971;71(1 Pt 2):204–17.CrossRefPubMed
21.
Zurück zum Zitat Sibony P, et al. Asymptomatic peripapillary subretinal hemorrhage: a study of 10 cases. J Neuroophthalmol. 2008;28(2):114–9.CrossRefPubMed Sibony P, et al. Asymptomatic peripapillary subretinal hemorrhage: a study of 10 cases. J Neuroophthalmol. 2008;28(2):114–9.CrossRefPubMed
22.
Zurück zum Zitat Wise GN, Henkind P, Alterman M. Optic disc drusen and subretinal hemorrhage. Trans Am Acad Ophthalmol Otolaryngol. 1974;78(2):212–9. Wise GN, Henkind P, Alterman M. Optic disc drusen and subretinal hemorrhage. Trans Am Acad Ophthalmol Otolaryngol. 1974;78(2):212–9.
23.
Zurück zum Zitat Gili P, et al. Anatomical and functional impairment of the nerve fiber layer in patients with optic nerve head drusen. Graefes Arch Clin Exp Ophthalmol. 2013;251(10):2421–8.CrossRefPubMed Gili P, et al. Anatomical and functional impairment of the nerve fiber layer in patients with optic nerve head drusen. Graefes Arch Clin Exp Ophthalmol. 2013;251(10):2421–8.CrossRefPubMed
24.
Zurück zum Zitat Spaide RF, Fujimoto JG, Waheed NK. Image artifacts in optical coherence tomography angiography. Retina (Philadelphia, Pa). 2015;35(11):2163–80.CrossRef Spaide RF, Fujimoto JG, Waheed NK. Image artifacts in optical coherence tomography angiography. Retina (Philadelphia, Pa). 2015;35(11):2163–80.CrossRef
Metadaten
Titel
Volume rendering of superficial optic disc drusen
A possible new imaging technique using optical coherence tomography angiography
verfasst von
Peter M. Maloca
Adnan Tufail
Catherine Egan
Sandrine Zweifel
Pascal W Hasler
Axel Petzold
J. Emanuel Ramos de Carvalho
Publikationsdatum
09.08.2017
Verlag
Springer Vienna
Erschienen in
Spektrum der Augenheilkunde / Ausgabe 6/2017
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI
https://doi.org/10.1007/s00717-017-0359-4

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