Histologic findings after surgical excision of optic nerve head drusen

Rashmi Kapur, Jose S. Pulido, Jerrold L. Abraham, Mithlesh Sharma, Bruce Buerk, Deepak P. Edward

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

PURPOSE: To report the histopathologic findings of a case of bilateral massive optic nerve head (ONH) drusen. METHODS: A 59-year-old man presented with bilateral massive ONH drusen and secondary compromise of the retinal vasculature leading to vision of counting fingers at 1 ft in the left eye and 20/30 in the right eye. The inferior one half of the left ONH druse was excised resulting in no light perception vision postoperatively. RESULTS: Energy-dispersive spectroscopy suggested the composition of the ONH druse to be calcium phosphate (Ca3[PO4]2), which has implications on pathogenesis of neuronal cell death in ONH drusen. Scanning electron microscopy demonstrated embedded metal particles, likely to be remnants of the instruments used. CONCLUSION: Massive ONH drusen are actually one large druse that has multiple excrescences on its surface giving it the variegated appearance. Although surgical excision of ONH drusen may be technically possible, consideration should be given to improvements in instrumentation and patient selection criteria.

Original languageEnglish (US)
Pages (from-to)143-146
Number of pages4
JournalRetina
Volume28
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Disk drusen
  • Optic nerve head drusen
  • Vitrectomy

ASJC Scopus subject areas

  • Ophthalmology

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