Young Adults With Anterior Ischemic Optic Neuropathy: A Multicenter Optic Disc Drusen Study Publisher Pubmed



Hamann S¹ ; Malmqvist L¹ ; Wegener M¹ ; Fard MA² ; Biousse V² ; Bursztyn L⁴ ; Citirak G¹ ; Costello F⁵ ; Crum AV⁶ ; Digre K⁶ ; Fraser JA^{4, 7} ; Hunabaron R^{8, 9} ; Katz B⁶ ; Lawlor M¹⁰ Show All Authors
Source: American Journal of Ophthalmology Published:2020

Abstract

Purpose: Optic disc drusen (ODD), present in 2% of the general population, have occasionally been reported in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION). The purpose of this study was to examine the prevalence of ODD in young patients with NA-AION. Design: Retrospective, cross-sectional multicenter study. Methods: All patients with NA-AION 50 years old or younger, 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 ODDS Consortium guidelines. NA-AION eyes with ODD were termed “ODD-AION”; those without were termed “NODD-AION”. Results: A total of 65 patients (127 eyes) with NA-AION were included (mean 41 years old). Of the 74 eyes with NA-AION, 51% had ODD-AION, whereas 43% of fellow eyes without NA-AION had ODD (P =.36). No significant differences were found between ODD-AION and NODD-AION eyes in terms of Snellen best-corrected VA or perimetric mean deviation. According to EDI-OCT results, 28% of eyes with NODD-AION had peripapillary hyperreflective ovoid mass-like structures (PHOMS); 7% had hyperreflective lines, whereas 54% with ODD-AION had PHOMS; and 66% had hyperreflective lines (P =.006 and P <.001, respectively). Conclusions: Most of these 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. This study suggests ODD-AION be recognized as a novel diagnosis. © 2020 Elsevier Inc.