Share this article on:

Assessment of Optic Nerve Head Drusen Using Enhanced Depth Imaging and Swept Source Optical Coherence Tomography

Silverman, Anna L. BA; Tatham, Andrew J. FRCOphth; Medeiros, Felipe A. MD, PhD; Weinreb, Robert N. MD

Section Editor(s): Biousse, Valérie MD; Galetta, Steven MD

Journal of Neuro-Ophthalmology: June 2014 - Volume 34 - Issue 2 - p 198–205
doi: 10.1097/WNO.0000000000000115
State-of-the-Art Review

Background: Optic nerve head drusen (ONHD) are calcific deposits buried or at the surface of the optic disc. Although ONHD may be associated with progressive visual field defects, the mechanism of drusen-related field loss is poorly understood. Methods for detecting and imaging disc drusen include B-scan ultrasonography, fundus autofluorescence, and optical coherence tomography (OCT). These modalities are useful for drusen detection but are limited by low resolution or poor penetration of deep structures. This review was designed to assess the potential role of new OCT technologies in imaging ONHD.

Evidence Acquisition: Critical appraisal of published literature and comparison of new imaging devices to established technology.

Results: The new imaging modalities of enhanced depth imaging optical coherence tomography (EDI-OCT) and swept source optical coherence tomography (SS-OCT) are able to provide unprecedented in vivo detail of ONHD. Using these devices it is now possible to quantify optic disc drusen dimensions and assess integrity of neighboring retinal structures, including the retinal nerve fiber layer.

Conclusions: EDI-OCT and SS-OCT have the potential to allow better detection of longitudinal changes in drusen and neural retina and improve our understanding of drusen-related visual field loss.

Department of Ophthalmology, Hamilton Glaucoma Center, University of California, San Diego, California.

Address correspondence to Anna L. Silverman, BA, Department of Ophthalmology, Hamilton Glaucoma Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0946; E-mail:

Supported in part by the National Institutes of Health/National Eye Institute grant EY021818 (F.A.M.) and Core grant P30EY022589; unrestricted grant from Research to Prevent Blindness.

F. A. Medeiros receives research support from Carl-Zeiss Meditec, Topcon, and Reichert; R. N. Weinreb receives research support from Carl-Zeiss Meditec, Optovue, Kowa, Nidek, and Topcon; A. J. Tatham, F. A. Medeiros, and R. N. Weinreb receive research support from Heidelberg Engineering; F. A. Medeiros and R. N. Weinreb are consultants to Carl-Zeiss Meditec, Inc; and R. N. Weinreb is a consultant to Topcon.

© 2014 by North American Neuro-Ophthalmology Society