Hamann S, Malmqvist L, Wegener M, Biousse V, Bursztyn L, Citirak G, Costello F, Crum AV, Digre K, Fard MA, Fraser JA, Huna-Baron R, Katz B, Lawlor M, Newman NJ, Peragallo JH, Petzold A, Sibony PA, Subramanian PS, Warner JE, Wong SH, Fraser CL; Optic Disc Drusen Studies Consortium. Young Adults with Anterior Ischemic Optic Neuropathy: A Multicenter Optic Disc Drusen Study. Am J Ophthalmol. 2020 Apr 13. pii: S0002-9394(20)30164-1. doi: 10.1016/j.ajo.2020.03.052. [Epub ahead of print]
Optic disc drusen (ODD), present in 2% of the general population, have occasionally been reported in patients with non-arteritic anterior ischemic optic neuropathy (NA-AION). The purpose of this study was to examine the prevalence of ODD in young patients with NA-AION.
retrospective, cross-sectional multicenter study.
All patients with NA-AION age 50 years or less, seen in neuro-ophthalmology clinics of the international ODDS (Optic Disc Drusen Studies) Consortium between April 1, 2017, and March 31, 2019, were identified. Patients were included if ODD were diagnosed by any method, or if ODD were excluded by enhanced-depth imaging optical coherence tomography (EDI-OCT) using the ODDS Consortium guidelines. NA-AION eyes with ODD were termed “ODD-AION”; those without were termed “NODD-AION”.
Sixty-five patients (127 eyes) with NA-AION were included (mean age 41 years). Of the 74 eyes with NA-AION, 51% had ODD (ODD-AION), while 43% of (fellow) eyes without NA-AION had ODD (P=0.36). No significant difference was found between ODD-AION and NODD-AION eyes in terms of Snellen BCVA or perimetric mean deviation. On EDI-OCT, 28% of eyes with NODD-AION had peripapillary hyperreflective ovoid mass-like structures (PHOMS) and 7% had hyperreflective lines while 54% with ODD-AION had PHOMS and 66% had hyperreflective lines (P=0.006 and P<0.001, respectively).
The majority of our young NA-AION patients had ODD. This indicates that ODD may be an independent risk factor for the development of NA-AION, at least in younger patients. We suggest ODD-AION be recognized as a novel diagnosis.