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Optic disc drusen: a systematic review

Up-to-date and future perspective

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Abstract

Background

Optic disc drusen (ODD) are acellular deposits in the prelaminar optic nerve head. The most accredited theory is that they are secondary to abnormalities in axonal metabolism and degeneration, but the pathogenesis is not clear to date.

Clinical manifestation

Although ODD are often considered a benign condition, the great majority of patients with ODD show visual field defects and are at higher risk for developing anterior ischemic optic neuropathy. ODD are classified as superficial or buried, with the latter being often misdiagnosed as papilledema with optic nerve head swelling, leading to an unnecessary investigation for causes of increased intracranial pressure.

Aim

The recent technological improvements in OCT imaging which allowed an earlier and more certain diagnosis even of the smallest ODD, renovated the interest around this pathology. However, an updated systematic review is still missing. Therefore, the aim of this work is to provide a concise yet comprehensive overview of the current state of art, focusing on pathophysiology, clinical presentation, diagnostic methods, treatment modalities and potential future perspectives of this condition.

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Acknowledgements

This study received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Biomedical Science, Humanitas University, 20090, Pieve Emanuele, Milano, Italy

    Davide Allegrini, Luca Pagano, Alfredo Borgia, Tania Sorrentino & Mario R. Romano

  2. Eye Unit, Department of Ophthalmology, Humanitas Gavazzeni-Castelli, 24128, Bergamo, Italy

    Davide Allegrini, Luca Pagano, Mariantonia Ferrara, Alfredo Borgia, Tania Sorrentino & Mario R. Romano

  3. Eye Clinic, Department of Bioscience, University of Milan, 20142, Milan, Italy

    Giovanni Montesano

  4. National Cancer Institute IRCCS Foundation, Via Venezian, 1, 20133, Milan, Italy

    Martina Angi

  5. Department of Bioscience, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milano, Italy

    Luca Pagano

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  1. Davide Allegrini
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All authors equally contributed to conception and design and to interpretation of data. All authors drafted the article and approved its final version.

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Correspondence to Luca Pagano.

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Allegrini, D., Pagano, L., Ferrara, M. et al. Optic disc drusen: a systematic review. Int Ophthalmol 40, 2119–2127 (2020). https://doi.org/10.1007/s10792-020-01365-w

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