Open AccessThe Role of Optical Coherence Tomography in Differentiating Optic Disc Drusen from Optic Disc Edema
Author(s) -
Fiona Costello,
Lasse Malmqvist,
Steffen Hamann
Publication year - 2019
Publication title -
asia-pacific journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.163
H-Index - 20
ISSN - 2162-0989
DOI - 10.22608/apo.2018124
Subject(s) - papilledema , medicine , optical coherence tomography , optic nerve , drusen , raised intracranial pressure , intracranial pressure , optic disc , context (archaeology) , ophthalmology , clinical practice , radiology , glaucoma , retinal , paleontology , family medicine , biology
An elevated optic nerve head can be an ominous sign, sometimes signifying an underlying basis for raised intracranial pressure. Alternatively, patients may harbor a different mechanism for this optic nerve head appearance, including optic disc drusen (ODD), which does not confer any life-threatening implications. It is important to refine the approach to distinguishing ODD from papilledema because this is a relatively common, and important, conundrum encountered in clinical practice. Optical coherence tomography (OCT) is a noninvasive, readily accessible, and cost-effective ocular imaging technique that can improve the diagnostic accuracy for detecting ODD; or, instead, increase the index of suspicion for papilledema, thus prompting additional investigations needed to identify (or exclude) potential causes of raised intracranial pressure. In this review, we will discuss the value of OCT in the diagnostic approach to cases of mild optic disc elevation, with acknowledgment of the potential pearls and pitfalls of this imaging technology. In particular, we will emphasize the helpful role OCT can play in differentiating cases of ODD from mild papilledema in the context of idiopathic intracranial hypertension (IIH).