Morris Robert W, Ellerbrock Joy M, Hamp Ania M, Joy Jeffrey T, Roels Philip, Davis Charles N
W.G. Hefner VA Medical Center, Salisbury, North Carolina, USA.
Optometry. 2009 Feb;80(2):83-100. doi: 10.1016/j.optm.2008.11.004.
Optic nerve head drusen (ONHD) is a relatively uncommon condition that results from calcific degeneration of axons within the optic nerve. The abnormal drusen bodies can enlarge, compressing normal nerve structures, and ultimately may result in vision loss. Drusen often are discovered through clinical evaluation with a dilated funduscopic examination. Ancillary testing, including computed tomographic (CT) imaging, B-scan ultrasonography, autofluorescence imaging, nerve fiber layer imaging, and threshold visual field evaluation are helpful to confirm the existence of ONHD and to evaluate for progression of this condition.
This case report discusses the clinical presentation of a patient with advanced visual field loss from ONHD and the ancillary testing used to confirm the diagnosis. A complete review of literature on ONHD is discussed.
Currently, there is no cure or direct treatment for progressive vision loss or complications that may develop from ONHD. Useful diagnostic tools include serial automated threshold visual fields, nerve fiber layer analysis, and fundus photography. It is suggested that ocular hypotensive agents be used to lower intraocular pressure prophylactically to prevent further nerve fiber layer and optic nerve damage.
视神经乳头 drusen（ONHD）是一种相对罕见的疾病，由视神经内轴突的钙化变性引起。异常的 drusen 体可增大，压迫正常神经结构，最终可能导致视力丧失。Drusen 通常通过散瞳眼底检查的临床评估发现。辅助检查，包括计算机断层扫描（CT）成像、B 超超声检查、自发荧光成像、神经纤维层成像和阈值视野评估，有助于确认 ONHD 的存在并评估该疾病的进展。
本病例报告讨论了一名因 ONHD 导致严重视野缺损患者的临床表现以及用于确诊的辅助检查。还讨论了关于 ONHD 的文献综述。
目前，对于 ONHD 可能导致的进行性视力丧失或并发症，尚无治愈方法或直接治疗手段。有用的诊断工具包括系列自动阈值视野检查、神经纤维层分析和眼底摄影。建议预防性使用降眼压药物以降低眼压，防止进一步的神经纤维层和视神经损伤。
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