To describe the clinical features of hemorrhagic complications secondary to optic nerve head drusen (ONHD) using spectral domain optical coherence tomography (SD-OCT).
Sixty-three consecutive patients with SD-OCT–documented ONHD who presented at Seoul National University Bundang Hospital from December 2009 to July 2012 were included. Full ophthalmologic examinations, including fundus photographs, SD-OCT, fundus angiography, and visual field tests were analyzed in a total of 101 ONHD-positive eyes from 63 patients.
Hemorrhagic ONHD complications were found in 7 eyes (7%) from a total of 101 eyes with ONHD. All of them had buried ONHD (visualized with SD-OCT) and myopia (mean spherical equivalent = −4.00 ± 2.35 diopters). Patients with ONHD hemorrhagic complications had smaller disk diameters than patients without hemorrhagic complications (1,308 ± 166 vs. 1,555 ± 217 μm, P = 0.004). Peripapillary hemorrhages were classified into the following 3 types based on SD-OCT findings: subretinal (6 eyes, 86%), retinal (5 eyes, 71%), and vitreous hemorrhage (4 eyes, 57%). Six patients (86%) complained of the recent onset of visual symptoms, but visual acuities at presentation were 20/20 in all patients. In the three patients who were followed up, most hemorrhages were absorbed without complications.
Peripapillary hemorrhage can often occur in patients with buried ONHD and small disk diameters. As SD-OCT can be used to visualize ONHD beneath hemorrhage, it is helpful with the differential diagnosis and follow-up evaluation.
Spectral domain optical coherence tomography is useful in the differential diagnosis of peripapillary hemorrhage, including hemorrhagic complications of buried optic nerve head drusen.
*Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea;
†Department of Ophthalmology, 15th Special Missions Wing, Republic of Korea Air Force, Seongnam, Korea; and
‡Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
Reprint requests: Se Joon Woo, MD, Department of Ophthalmology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do 463-707, Korea; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.
K. M. Lee and J.-M. Hwang equally contributed to the work and therefore should be considered equivalent authors.