Papillary drusen. Descriptive analysis

Abstract

INTRODUCTION: Papillary drusen are deposits of calcified material at the level of the optic nerve head. It’s
can be difficult to distinguish from true optic nerve swelling. Its correct identification is relevant due to the
visual and systemic implications of the diagnosis of true papilledema.
OBJECTIVE: To characterize clinically a group of patients diagnosed with papillary drusen.
MATERIAL AND METHODS: A retrospective descriptive study of 39 eyes with papillary pseudoedema
secondary to optic nerve drusen was performed. Data from the medical history were retrieved and characteristics
of the ophthalmological medical examination and complementary methods such as optical coherence
tomography (OCT), computerized visual fields, and ocular ultrasound were analyzed.
RESULTS: 39 eyes of 20 patients with papillary drusen were studied. The average age at diagnosis was 9 years.
The majority did not report pathological or heredofamilial background. The main complain consultation was routine check out and the second was headache. The 56% had excellent visual acuity, 20% good, 2.5% regular
and 5% had poor visual acuity. There were 36% emmetropic eyes, 41% hypermetropics and 23% myopia.
The most representative findings in the fundus were swollen disks, appearing in (71,8% IC95% 57,9-86) of the
cases, optic nerve with ill-defined and vascular tortuosity, appeating in 43,6% (IC95% 27,4-58,5) of the cases.
In all cases the ultrasound was diagnostic, showing hyperechoic images withing the optic nerve. No relevant
findings were found at CVC.
CONCLUSIONS: Papillary drusen is a frequent disease that can be found in every day practice.
Ophthalmologist should be aware of this to avoid misdiagnosis.