This 65YO female presented with dramatic bilateral optic nerve drusen with severe visual field defects. Vision was 20/20 OU.
Learning Points:
Optic disc drusen are refractile calcific concretions that form anterior to the lamina cribrosa. They are felt to be extruded extracellular calcified mitochondria and may be inherited as an autosomal dominant trait.
Most patients are asymptomatic, but some can develop progressive visual field defects or central vision loss.
There is no treatment for the drusen themselves, although symptomatic macular neovascularization can be treated with thermal laser, photodynamic therapy, or anti-VEGF injections.
