Optic disc drusen (ODD) is only present in 2% of the general population, but approximately half of patients with non-arteritic anterior ischemic optic neuropathy (NAION) who are 50 years old or younger have it, researchers say. In fact, even in patients who had NAION in one eye, nearly half had ODD in their healthy fellow eye as well. “This indicates that ODD may be an independent risk factor for the development of NAAION, at least in younger patients,” the research team wrote. “We suggest ODD-AION be recognized as a novel diagnosis.”

The investigators looked at 127 eyes of 65 patients from April 1, 2017 to March 31, 2019. Of the 74 eyes with NAION, researchers found ODD in 51%. For those same patients, 43% had drusen present in the fellow healthy eye. The drusen didn’t seem to impact the Snellen best-corrected visual acuities or perimetric mean deviation of NAION patients. On enhanced-depth imaging OCT (EDI-OCT), 28% of eyes with NAION but no drusen had peripapillary hyperreflective ovoid mass-like structures (PHOMS) and 7% had hyper-reflective lines. Of NAION patients with drusen, 54% had PHOMS and 66% had hyperreflective lines.

Patients were included if ODD were diagnosed by any method, or if ODD were excluded by enhanced-depth imaging optical coherence tomography.

Hamann S, Malmqvist L, Wegener M, et al. Young adults with anterior ischemic optic neuropathy: a multicenter optic disc drusen study. Am J Ophthalmol. April 13, 2020. [Epub ahead of print].