Background Optic disc drusen (ODD) can cause retinal nerve fibre layer (RNFL) defects with progressive visual field (VF) loss. Microvascular changes are discussed as a cause. We measured the vessel density (VD) of the optic disc in ODD using optical coherence tomography angiography and compared it with a normal population. Another intent was to determine the sensitivity and correlations in comparison with functional (VF) and structural parameters (RNFL, minimum rim width (MRW), ganglion cell complex (GCC)).
Methods We analysed the VD of 25 patients with ODD and an age-matched control population including 25 healthy participants using AngioVue (Optovue, Fremont, CA, USA). We obtained data about RNFL, GCC, Bruch’s membrane opening MRW (Spectralis HRA & OCT; Heidelberg Engineering, Germany) and VF (standard automated perimetry; SITA 24-2). Low image quality and pathologies interfering with the diagnostics were excluded. Parametric data were analysed using the t-test and non-parametric values using the Mann-Whitney U test. Linear regression analysis was used to determine correlations using the Bravais-Pearson test.
Results The VD was significantly reduced in the ODD group especially the peripapillary capillary VD (n=45 vs 50 eyes; mean 43.15% vs 51.70%). Peripapillary RNFL thickness correlated with the VD significantly (r=0.902 (n=44), 0.901 (n=44), 0.866 (n=45)). The RNFL analysis showed a reduction in ODD, especially the superior hemisphere (mean 107 µm, 129 µm; 49 vs 50 eyes). The GCC was significantly lower in the ODD group (n=38 vs 40; mean 87 µm vs 98 µm). Positive correlation between the VD and the GCC was significant (n=37, r=0.532). There is a significant negative correlation (n=19; r=−0.726) between the VD and the pattern standard deviation (PSD).
Conclusion This study reveals significant peripapillary microvascular changes in patients with ODD correlating with the RNFL and GCC reduction. There is a negative correlation between the PSD and the VD.
- optic disc drusen
- optic nerve head drusen
- optical coherence tomography
- optical coherence tomography angiography
- ganglion cell complex
- retinal nerve fiber layer
- visual field defect
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Contributors HE and MM contributed equally in planning and outlining the question of performing OCTA scans in patients with optic disc drusen. MM is an expert for glaucoma and we were both interested if according to glaucoma the OCTA scans would show a reduced vessel density in patients with optic disc drusen. In the following patient data and control group participants were collected by HE and OCT and OCTA scans were performed by HE, JR and NM. The analysis and interpretation of data were performed by HE and MS. SGP is the chief of medicine at our institution and was of helpful advice for processing the paper and a part of the institutional review board. The paper was written by HE and MM.
Funding MS: Oertli, Santen, Zeiss, Staar, Oculus. SGP: consultant—Oertli, Novartis; grants—Alcon, Bayer, Novartis, Zeiss, Acufocus, 1st Q, Allergan, iStar, Novartis.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study was performed according to the Declaration of Helsinki and was approved by the institutional review board and the expert ophthalmologists at my institution.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on request.