Optic Nerve Head Drusen in Black Patients

• Authors: Matthew J. Thurtell, Emory University; Valerie Biousse, Emory University; Beau Benjamin Bruce, Emory University; Nancy J. Newman, Emory University
• Journal Title: Journal of Neuro-Ophthalmology
• Volume: Volume 32, Number 1
• Publisher: Lippincott, Williams & Wilkins | 2012-03, Pages 13-16
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/WNO.0b013e3182268655
• Subjects: Biology, Neuroscience; Health Sciences, Opthamology
• Keywords: Optic Nerve; Drusen; Ethnicity

Abstract

Background: Several studies have suggested racial differences in the prevalence of optic nerve head drusen (ONHD). We aimed to determine the percentage of patients with ONHD who are black, and to describe the clinical, ophthalmoscopic, and perimetry findings in these patients. Methods: We conducted a retrospective chart review of all patients with ONHD seen at our institution between 1989 and 2010. Only black patients with ONHD confirmed on either funduscopy or B-scan ultrasonography were included. Demographic and clinical findings in these patients were recorded and analyzed. Results: Of 196 patients with confirmed ONHD, 10 (5.1%) were black (7 women; ages 8–61 years). Six of the 10 patients had bilateral ONHD. The ONHD were buried in 11 of 16 eyes with ONHD, and exposed in 5 of 16 eyes. Fifteen of 16 eyes with ONHD had small cupless optic nerve heads. Visual fields were normal in 4 of 16 eyes with ONHD. In the other eyes, visual field defects included an enlarged blind spot (5 eyes), constricted field (5 eyes), nasal defect (2 eyes), central defect (1 eye), and generalized depression (1 eye). Visual field defects were present in 4 of 5 eyes (80%) with exposed ONHD and 8 of 11 eyes (72.7%) with buried ONHD. None of the patients were related and none of their examined family members had exposed ONHD on funduscopic examination. Conclusion: ONHD are rare in blacks, possibly due to the presence of a larger cup-to-disc ratio or a lack of predisposing genetic factors. Visual field defects are common in black patients with both exposed and buried ONHD.