VASCULAR PAPILLARY ANOMALIES AND COMPLICA TIONS IN OPTIC DISC DRUSEN

Background Drusen of the optic disc are associated with slowly progres sive optic neuropathy, characterized by accumulation of acellular lami nated concretions in the prelaminar portion of the optic nerve. Papill ary hemorrhages and vascular shunts have been reported with disc druse n but their frequency and clinical significance is not well known. Met hods Retrospective study of fundus photographies of 116 patients with disc drusen referred to the National Hospital for Neurology and Neuros urgery, London, between 1965 and 1991. Results Hrmorrhages were found in 23 eyes from 16/116 (13,8%) patients. Most cases (68.8%, 11/16 case s) occurred in patients with buried drusen, and most hemorrhages were deeply located. Vascular shunts were present in 6.9% (8/116 cases), mo st frequently in patients with exposed drusen (6/8 cases). most being of the venous type (7/8 cases). Discussion Vascular anomalies are not rare in disc drusen, as 20.7% (24/116 cases) of our patients presented either disc hemorrhages or shunt vessels. Their presence supports the hypothesis of the slowly progressive nature of disc drusen and the mo re advanced stage of optic neuropathy in such eyes.