Abstract: Optic disc drusen (ODD) is a condition characterized by calcified deposits within the optic nerve head. This article provides a comprehensive review of ODD, elucidating its etiology, clinical presentations, diagnostic approaches, and management strategies. By enhancing our understanding of ODD, ophthalmologists can accurately diagnose and manage this condition, thereby improving patient care and outcomes.

Introduction: Optic disc drusen poses diagnostic challenges due to its variable presentation and potential mimicry of optic nerve head pathology. Understanding the underlying mechanisms and clinical features of ODD is crucial for appropriate management and patient counseling.

Etiology: Optic disc drusen are thought to result from abnormal axonal metabolism, leading to the accumulation of extracellular material within the optic nerve head. While the exact etiology remains unclear, ODD can occur sporadically or be associated with systemic conditions such as pseudoxanthoma elasticum or retinitis pigmentosa.

Clinical Manifestations: The clinical presentation of ODD varies widely, ranging from asymptomatic to visual field defects, visual disturbances, or even compressive optic neuropathy in severe cases. Fundoscopic examination typically reveals bilateral, elevated optic nerve heads with characteristic calcified deposits. Additionally, ODD may be associated with vascular anomalies, peripapillary hemorrhages, or retinal nerve fiber layer defects.

Diagnosis: Diagnosing ODD requires a thorough ophthalmic examination, including dilated fundoscopy, optical coherence tomography (OCT), fundus autofluorescence, and B-scan ultrasonography. OCT has emerged as a valuable tool for detecting and monitoring ODD, providing detailed visualization of drusen anatomy and associated retinal changes.

Management: Management of ODD focuses on monitoring for progression of visual field defects or signs of optic nerve compression. Patients with symptomatic ODD may benefit from visual field testing, neuroimaging, or neuro-ophthalmologic consultation to assess for associated complications. Treatment options for symptomatic ODD are limited, but may include neuroprotective agents or surgical interventions such as optic nerve decompression in cases of significant visual impairment.

Conclusion: Optic disc drusen represent a challenging condition for ophthalmologists due to its variable presentation and potential visual complications. Through a comprehensive understanding of ODD etiology, clinical manifestations, diagnostic modalities, and management strategies, ophthalmologists can provide optimal care for patients with this condition.

For further reading and reference:

• American Academy of Ophthalmology – Optic Disc Drusen Information: https://www.aao.org/
• National Eye Institute – Optic Disc Drusen Information Page: https://www.nei.nih.gov/