Patterns of macular inner retinal layers involvement in eyes with optic nerve head drusen

Abstract

Purpose: The purpose of this study was to investigate the macular inner retinal layers involvement in eyes with optic nerve head drusen (ONHD) using spectral-domain optical coherence tomography (SD-OCT). Methods: An observational case series was carried out. Consecutive patients with ONHD and age-matched healthy individuals were enrolled from a single center. Key exclusion criteria were significant media opacity, best-corrected visual acuity ≤20/40, and the presence of any ocular comorbidity. After inclusion, all patients underwent SDOCT imaging, visual field (VF) testing (standard automated perimetry), and optic disc digital imaging. For SD-OCT, macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) protocols were obtained. SD-OCT examinations were classified as normal or abnormal (and subsequently as focal or diffuse loss pattern) based on previously described color-coded criteria. Results: A total of 19 eyes with ONHD and 20 control eyes were included in the study. The VF mean deviation for ONHD eyes was −4.6 ± 3.9 dB. Regarding macular inner retinal layers (GCC protocol) analysis in ONHD eyes, nine eyes (47.4%) had significant macular GCC thinning, of which seven presented focal loss pattern and two diffuse loss pattern. Overall, both macular and pRNFL parameters were significantly thinner in eyes with ONHD when compared to healthy controls (P < 0.05). Analyzing the ability of the SD-OCTs normative database to detect abnormalities, 42.1% of the patients were presented abnormalities in both pRNFL and GCC parameters, while only one case presented an SD-OCT abnormality restricted to the macular GCC protocol. Conclusions: Investigating macular inner retinal layers involvement in eyes with ONHD, we found detectable macular damage by SD-OCT in almost half of the cases. In most of these cases, macular damage had a focal loss pattern and was accompanied by concomitant pRNFL thinning.