Researchers recently observed demarcation of buried optic disc drusen (ODD) from the optic nerve axons on en face OCT and poor vascular perfusion of buried ODD on OCT angiography (OCT-A), suggesting that buried ODD are deposited around the optic disc rather than the herniated optic nerve axon fibers.

This retrospective, cross-sectional study evaluated the medical records of 61 patients (92 eyes) with buried ODD, 45 patients (62 eyes) with optic disc edema and 42 normal-appearing fellow eyes. 

On en face OCT, the investigators found that buried ODD appeared as hyper-reflective, kidney-shaped masses well demarcated from the optic nerve axons; optic disc edema, however, appeared as ill-defined boundaries confluent with the retinal nerve fibers. On OCT-A, they noted that 25.0% of eyes with buried ODD showed a C-shaped vessel density decrease in the nasal radial peripapillary capillary layer, while 40.3% of eyes with optic disc edema had non-specific focal vessel density decrease around the optic nerve head. 

The study authors added that larger buried ODD were significantly associated with a vessel density decrease on OCT-A. They also discovered that the disc diameter positively correlated with the buried ODD area and negatively correlated with the buried ODD height.

Kim MS, Lee KM, Hwang JM, et al. Morphologic features of buried optic disc drusen on en face optical coherence tomography and optical coherence tomography angiography. Am J Ophthalmol. January 24, 2020. [Epub ahead of print].