Opitc nerve drusen
 

The edge of the optic disc is irregular and there are lumpy, yellowish materials within the disc. The optic cup is absent and the blood vessels show abnormal branching pattern. Look for associated signs: angioid streaks retinitis pigmentosa

Questions:

1. What are the yellowish materials made up of?

Answer
Optic nerve drusen results from axonal degeneration and are made up of acellular calcified concentric laminations.

2. How can you confirm the diagnosis?

Answer
Examination of the family members; optic nerve drusen can be dominantly inherited.
Fluorescence angiography shows autofluorescence and late staining of the drusen.
B scan or CT scan can show calcification at the optic nerve head.

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