This 30YO male presented with dramatic bilateral optic nerve drusen. Vision was 20/20 OD and 20/200 in his amblyopic OS.
A spontaneously involuted macular neovascularization (MNV) is noted in the nasal macula. The drusen are markedly hyper-autofluorescent.
Observation was recommended.
Learning Points:
Optic disc drusen (ODD) are refractile calcific concretions that form anterior to the lamina cribrosa. They are thought to be extruded, extracellular, calcified mitochondria and may be inherited as an autosomal dominant trait.
MNV is a known complication of ODD. These can spontaneously involute, as in our patient, or can be treated with thermal laser, photodynamic therapy, or anti-VEGF injections.
