Optic Disc Drusen

  • Nicolas Jean Paul Peres
Part of the Retina Atlas book series (RA)


Optic disc drusen (ODD) are acellular bodies of hyaline deposits located both intracellularly and extracellularly first described by Muller in 1858 (Muller 1858; Hamann et al. 2018). The main clinical significance of optic disc drusen is that they can simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an extensive, invasive, and unnecessary systemic work-up, including neuroimaging and lumbar puncture. An ODD prevalence of 2.4% has been found in autopsy studies, though it has been reported to be significantly lower using in vivo imaging modalities. The prevalence of ODD is higher in women and involvement is usually bilateral (Lorentzen 1966; Friedman et al. 1975).


  1. Atta HR. Imaging of the optic nerve with standardised echography. Eye. 1988;2(4):358–66.PubMedCrossRefGoogle Scholar
  2. Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol. 2002;47(6):515–32.PubMedCrossRefGoogle Scholar
  3. Erkkila H. Optic disc drusen in children. Acta Ophthalmol. 1977;55(Suppl 129):7–44.Google Scholar
  4. Friedman AH, Gartner S, Modi SS. Drusen of the optic disc. A retrospective study in cadaver eyes. Br J Ophthalmol. 1975;59:413–21.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Frisen L. Evolution of drusen of the optic nerve head over 23 years. Acta Ophthalmol. 2008;86(1):111–2.PubMedCrossRefGoogle Scholar
  6. Gifford H. An unusual case of hyaline bodies in the optic nerve. Arch Ophthalmol. 1895;24:395–401.Google Scholar
  7. Hamann S, Malmqvist L, Costello F. Optic disc drusen: understanding an old problem from a new perspective. Acta Ophthalmol. 2018;96(7):673–84.PubMedCrossRefGoogle Scholar
  8. Heidary G, Rizzo JF 3rd. Use of optical coherence tomography to evaluate papilledema and pseudopapilledema. Semin Ophthalmol. 2010;25(5–6):198–205.PubMedCrossRefGoogle Scholar
  9. Katz BJ, Pomeranz HD. Visual field defects and retinal nerve fiber layer defects in eyes with buried optic nerve drusen. Am J Ophthalmol. 2006;141(2):248–53. Scholar
  10. Kulkarni KM, Pasol J, Rosa PR, Lam BL. Differentiating mild papilledema and buried optic nerve head drusen using spectral domain optical coherence tomography. Ophthalmology. 2014;121(4):959–63.PubMedCrossRefGoogle Scholar
  11. Kurz-Levin MM, Landau K. A comparison of imaging techniques for diagnosing drusen of the optic nerve head. Arch Ophthalmol. 1999;117(8):1045–9.PubMedCrossRefGoogle Scholar
  12. Lee AG, Zimmerman MB. The rate of visual field loss in optic nerve head drusen. Am J Ophthalmol. 2005;139(6):1062–6. Scholar
  13. Lorentzen SE. Drusen of the optic disk. A clinical and genetic study. Acta Ophthalmol. 1966;44(Suppl 90):1–180.Google Scholar
  14. Muller H. Anatomische Beitrage zur Ophthalmologie ueber niveau-Veranderungen an der eintrittstelle des Sehnerven. Albrecht von Graefes Arch Klin Exp Ophthalmol. 1858;4:1–40.CrossRefGoogle Scholar
  15. Mullie MA, Sanders MD. Scleral canal size and optic nerve head drusen. Am J Ophthalmol. 1985a;99(3):356–9.PubMedCrossRefGoogle Scholar
  16. Mullie MA, Sanders MD. Computed tomographic diagnosis of buried drusen of the optic nerve head. Can J Ophthalmol. 1985b;20(3):114–7.PubMedGoogle Scholar
  17. Mustonen E. Pseudopapilloedema with and without verified optic disc drusen. A clinical analysis II: visual fields. Acta Ophthalmol. 1983;61(6):1057–66.CrossRefGoogle Scholar
  18. Pineles SL, Arnold AC. Fluorescein angiographic identification of optic disc drusen with and without optic disc edema. J Neuroophthalmol. 2012;32(1):17–22.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Sacks JG, O’Grady RB, Choromokos E, Leestma J. The pathogenesis of optic nerve drusen. A hypothesis. Arch Ophthalmol. 1977;95(3):425–8.PubMedCrossRefGoogle Scholar
  20. Samples JR, van Buskirk M, Shults WT, Van Dyk HJ. Optic nerve head drusen and glaucoma. Arch Ophthalmol. 1985;103(11):1678–80.PubMedCrossRefGoogle Scholar
  21. Sanders MD, Ffytche TJ. Fluorescein angiography in the diagnosis of drusen of the disc. Trans Ophthalmol Soc U K. 1967;87:457–68.PubMedGoogle Scholar
  22. Savino PJ, Glaser JS, Rosenberg MA. A clinical analysis of pseudopapilledema. II. Visual field defects. Arch Ophthalmol. 1979;97:71–5.PubMedCrossRefGoogle Scholar
  23. Silverman AL, Tatham AJ, Medeiros FA, Weinreb RN. Assessment of optic nerve head drusen using enhanced depth imaging and swept source optical coherence tomography. J Neuroophthalmol. 2014;34(2):198–205.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Spencer WH. Drusen of the optic disk and aberrant axoplasmic transport. The XXXIV Edward Jackson memorial lecture. Am J Ophthalmol. 1978;85(1):1–12.PubMedCrossRefGoogle Scholar
  25. Tso MO. Pathology and pathogenesis of drusen of the optic nerve head. Ophthalmology. 1981;88:1066–80.PubMedCrossRefGoogle Scholar
  26. Wilkins JM, Pomeranz HD. Visual manifestations of visible and buried optic disc drusen. J Neuroophthalmol. 2004;24(2):125–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Nicolas Jean Paul Peres
    • 1
  1. 1.Department of OphthalmologyGovernador Celso Ramos HospitalFlorianópolisBrazil

Personalised recommendations