The influence of topical antiglaucoma drugs on the reduction of the decrease of visual field sensitivity due to optic nerve head drusen: Case report

Abstract

Optic nerve head drusen are congenital anomalies of the optic nerve, a form of calcium degeneration of axons of the optic nerve head. Initially asymptomatic, drusen may be one of the causes of progressive optic neuropathy. They are clinically presented as acellular, hyaline deposits of globular appearance in prelaminar segment of the optic nerve head. They occure due to: altered axonal transport, small diameter of scleral channel, compression and ischemia. Frequent complications include progressive visual field defects, ischemic optic neuropathy, central retinal artery or vein occlusion, or peripapillar neovascularization. Diagnostic tools: ophthalmoscopy, angiography, computerized perimetry, B-scan ultrasonography, CT, OCT, HRT, GDx, electrophysiological testing. The treatment is medicamentous, laser, or surgery. Most of the pilot studies confirms the benefit of topical hypotensive drugs even when the drusen are not associated with glaucoma. The decrease of intraocular pressure reduces compression of the optic nerve axons and improves reperfusion. This paper presents a young patient with bilateral optic nerve head drusen, progressive scotoma and topical hypotensive medication administered. After six months, scotoma and the loss of sensitivity were reduced. The effect of neuroprotective drugs is researched to reduce potential morbidity.