TY - JOUR
T1 - The Role of Optical Coherence Tomography in Differentiating Optic Disc Drusen from Optic Disc Edema
AU - Costello, Fiona
AU - Malmqvist, Lasse
AU - Hamann, Steffen
N1 - Copyright 2018 Asia-Pacific Academy of Ophthalmology.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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).
AB - 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).
KW - Diagnosis, Differential
KW - Humans
KW - Nerve Fibers/pathology
KW - Optic Disk/pathology
KW - Optic Disk Drusen/diagnosis
KW - Papilledema/diagnosis
KW - Retinal Ganglion Cells/pathology
KW - Tomography, Optical Coherence/methods
U2 - 10.22608/apo.2018124
DO - 10.22608/apo.2018124
M3 - Review
C2 - 29998632
SN - 2162-0989
VL - 7
SP - 271
EP - 279
JO - Asia-Pacific Journal of Ophthalmology
JF - Asia-Pacific Journal of Ophthalmology
IS - 4
ER -