20 Apr 2017 Assessing the optic nerve head for buried drusen · Trauma with poor view of the fundus to demonstrate vitreous hemorrhage or retinal detachment

Line scan images with a 4.0-mm diameter (radius, 2.0 mm) that were obtained from the fast optic disc scans on optical coherence tomography. The images represent a normal optic nerve (A), optic nerve head drusen with moderate (B) and marked (C) elevation, and optic disc edema with mild (D), moderate

Optic nerve head drusen were noted on computed tomography scan and confirmed with B-scan ultrasound. Diagnostic evaluation of optic nerve head drusen is accomplished utilizing a variety of techniques: Echography – Standardized A- and B-scan echography is very reliable due to the characteristic highly reflective nature of drusen and also provides the highest resolution available today (Davis 2003). Optic disc drusen are small collections of hyaline material located within the head of the optic nerve (CN II) at variable depths 1-3. The earliest signs of drusen formation histologically are small globular or plaque-like deposits in Bruch membrane of hyaline material, present in the majority of individuals, and perhaps congenital in nature 3 . Fluorescein angiography may be useful in diagnosing deeply buried drusen and may demonstrate a fluorescence spot during the late stages of angiogram.

B, In both eyes, B-scan echography demonstrated a highly reflective echo (arrows) persisting at a very low-gain setting in the region of the optic nerve head in both the transverse and longitudinal probe orientation (transverse orientation shown). Keywords: optic nerve drusen; B scan; papilledema 1. Introduction It is vital to di erentiate optic disc drusen (ODD) from papilledema to avoid unnecessary investigations in an otherwise asymptomatic patient [1]. Various modalities are available to diagnose ODD including ultrasound scan (USS), ocular coherence tomography (OCT), ﬂuorescein Visual information received by the eye is transmitted to the brain along the optic nerve.

Optic disc drusen are small collections of hyaline material located within the head of the optic nerve (CN II) at variable depths 1-3. The earliest signs of drusen formation histologically are small globular or plaque-like deposits in Bruch membrane of hyaline material, present in the majority of individuals, and perhaps congenital in nature 3 .

HOW CAN OPTIC NERVE DRUSEN AFFECT VISION? Although optic nerve drusen do not usually affect Drusen of the Optic Nerve. Drusen can also occur in the optic nerve.

Complete optic nerve avulsion was seen just in one case when the globe was surgically explored. Therefore, it is usually hard to diagnosis optic nerve avulsion by CT scan and MRI. Our patient was also asked for orbital CT scan and MRI. Because of retrobulbar hemorrhage MRI findings was not helpful. Orbital CT scan revealed optic disc with drusen.

The B‐scan provides a bidimensional anatomic image of the optic nerve head, and the A‐scan enables the cross‐sectional measurement of the ONW. Detection of the ‘doughnut’ or ‘crescent’ sign in the B‐Mode, an ONW of >3.3 mm in the retrobulbar area as observed in the A‐Mode, or a positive 30‐degree test was considered positive US findings. • Right of display = Posterior (Optic Nerve) – Probe marker always nasal or UP – Observe/Measure anterior-posterior extent • Use to recheck A scan measurements B-scan Echo Patterns Normal Eye - Horizontal Axial View Temporal Nasal Probe Orientation Extremely important !

för den optiska nerven i satser i "svep" -läget med en pulsupprepningshastighet av 1: I sådana fall är B-scan ultraljud och fluorescensangiografi till hjälp för att ställa Pseudo-congestive optic nerve head orsakad av drusen detekterades hos 9 patienter. Calcium produces bright signal at junction of the posterior globe and optic nerve on a CT scan. Optical coherence tomography (OCT): Although not necessary for diagnosis, OCT is helpful in detecting early nerve fiber layer thinning in cases of optic nerve head drusen, and can be predictive of visual field loss. B scan ultrasound optic disc drusen B-scan ultrasound can reveal an ovoid echogenic lesion at the junction of the retina and optic nerve. The degree of acoustic shadowing is proportional to the size of the echogenic focus. With papilledema, the intraorbital portion of the optic nerve is typically widened and will not decrease in width with prolonged lateral gaze (30 degree test).
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It is vital to differentiate optic disc drusen 20 Apr 2017 Assessing the optic nerve head for buried drusen · Trauma with poor view of the fundus to demonstrate vitreous hemorrhage or retinal detachment 9 Oct 2017 Differentiating disc drusen, especially those that are buried and not visible for FAF to not visualize the drusen, and we must rely on B-scan.

. Grippo TM, Shihadeh WA, Schargus M, Gramer E, Tello C, Liebmann JM, et al.
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The ability to record dense OCT scans with <30 μm between each B‐scan has made the method excellent for visualizing small structures such as ODD, in the optic nerve head. The role of OCT in ODD diagnostics has recently expanded greatly as the technique now is able to visualize deeper layers of the retina and optic nerve head (Merchant et al. 2013 ; Sato et al. 2013 ; Malmqvist et al. 2017a ).

A B Scan is an ultrasound test that is used over top of the patient's closed eyelid, that will show the buried drusen quite distinctly as small reflective particles within the optic nerve. Drusen of the Optic Nerve.

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The B‐scan provides a bidimensional anatomic image of the optic nerve head, and the A‐scan enables the cross‐sectional measurement of the ONW. Detection of the ‘doughnut’ or ‘crescent’ sign in the B‐Mode, an ONW of >3.3 mm in the retrobulbar area as observed in the A‐Mode, or a positive 30‐degree test was considered positive US findings.

Pearls. Incidentally found optic nerve drusen are common and are usually asymptomatic. The mean time for development of drusen detectable on B-scan was 2.7 years. At no point was there optic nerve sheath dilation on B-scan. In two children, CT scans were conducted and reported as B scan ultrasonography (USG) and Spectral domain optical coherence tomography were performed and bilateral optic nerve heads were diagnosed as ODD. We concluded that the pseudopapilledema must be taken into account before making papilledema diagnosis in patients with CM 1 to protect the patients from redundant interventional procedures. 2009-07-02 · Optic disc drusen are familial and are not uncommon.

Optical coherence tomography/scanning laser ophthalmoscopy (OCT/SLO) of normal control and optic nerve head drusen. (Top) Transverse OCT/SLO scan of healthy optic nerve, demonstrating smooth

B-scan is considered to have high sensitivity and specificity for the detection of ONHD.2,11 In the general patient, the optic nerve appears as a tubular structure with low homogenous reflectivity. Drusen appear as hyperreflective calcified bodies in the optic nerve and will continue to show increasing brightness even at a low gain. B, In both eyes, B-scan echography demonstrated a highly reflective echo (arrows) persisting at a very low-gain setting in the region of the optic nerve head in both the transverse and longitudinal probe orientation (transverse orientation shown).

2013 ; Malmqvist et al.