Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark.
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
Acta Ophthalmol. 2018 Nov;96(7):673-684. doi: 10.1111/aos.13748. Epub 2018 Apr 16.
Optic disc drusen (ODD) are acellular deposits located in the optic nerve head of up to 2.4% of the population. They may develop as by-products of impaired axonal metabolism in genetically predisposed individuals, in whom a narrow scleral canal is hypothesized to play a role. Although ODD are often considered as benign innocent bystanders, recognized as part of a routine ophthalmological examination, the vast majority of patients with ODD have visual field defects. Optic disc drusen (ODD)-associated complications with severe visual loss, most often due to anterior ischaemic optic neuropathy, are also known to occur. There are no treatments available to prevent or ameliorate the vision loss caused by ODD. In children, the ODD are usually uncalcified and buried within the optic nerve head tissue. In these cases, the condition can be difficult to diagnose, as it often resembles a papilloedema with optic nerve head swelling caused by raised intracranial pressure. During the teenage years, the ODD progressively become more calcified and probably also larger, which allow them to be visible on ophthalmoscopy. With the advent and proper utilization of high-resolution modalities of optical coherence tomography (OCT), it has now become possible to detect even the smallest and most deeply located ODD. This allows for ODD detection at a much earlier developmental stage than has previously been possible and enhances the possibilities of research in underlying mechanisms. A review of the literature on ODD was conducted using the PUBMED database. The review focuses on the current knowledge regarding pathogenesis, diagnostics, clinical disease-tracking methodologies, structure-function relationships and treatment strategies of ODD.
视盘玻璃膜疣（ODD）是位于视神经头部的无细胞沉积物，在 2.4%的人群中可见。它们可能是遗传易感性个体轴突代谢受损的副产品，有人假设狭窄的巩膜管在此过程中起作用。尽管 ODD 通常被认为是良性的无辜旁观者，被认为是眼科常规检查的一部分，但绝大多数 ODD 患者都有视野缺损。已知 ODD 还会引起与严重视力丧失相关的并发症，最常见的原因是前部缺血性视神经病变。目前尚无治疗方法可预防或改善 ODD 引起的视力丧失。在儿童中，ODD 通常未钙化且埋藏在视神经头部组织中。在这些情况下，由于颅内压升高导致视神经头部肿胀而引起的视乳头水肿，使得诊断变得困难。在青少年时期，ODD 逐渐变得更加钙化，可能也更大，这使得它们在检眼镜下可见。随着高分辨率光学相干断层扫描（OCT）等技术的出现和正确应用，现在甚至可以检测到最小和最深处的 ODD。这使得在以前不可能的更早发育阶段就可以检测到 ODD，并增强了对潜在机制的研究可能性。本文使用 PUBMED 数据库对 ODD 的文献进行了综述。综述重点介绍了 ODD 的发病机制、诊断、临床疾病跟踪方法、结构-功能关系和治疗策略的最新知识。
