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45 year old with bilateral VF defects

Posted by admin@meditred.com - Posted on 04/18/2016 01:29:31 Neuro ophthalmology


45 year old presents with vision of 20/20 OU; IOP 18 OD and 22 OS ; Pachymetery 545 OU; disc and VF attached.  What is the likelyhood that these discs will leak on FA?


Diagnosis: Bilateral optic nerve head drusen

FA typically causes staining of drusen in the late stages, blockage in early stages and autofluorescence on redfree picture. This is in contract to papilledema which demonstrates early diffuse hyperfluorescence with late leakage.

Fun facts

Calcified nodules with in the optic nerve head

Upto 2% of white population (rare in other races)

Bilateral in 85% of cases

Unknow pathology - Presumed to be related impaired axonal flow secondary to narrow scleral tunnel

Symptoms: Transident vision loss in 8%

VF loss in 85% (enlarged blindspot, arcuate defects, peripheral depression

Disc exam - irrregular margins, anomalous vascular branching pattern, pallor

B Scan- ODD is elevated and reflective on decreasing the sensitivity of the display and intraorbital portion is normal

FA:  staining of drusen in thE late stages, blockage in early stages and autofluorescence on redfree picture. 


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