Photo Essay|Articles in Press

Optic nerve drusen causing hemorrhages in three retinal layers

Published:February 16, 2023DOI:
      A young woman noticed blurry vision and floaters in her left eye. Ophthalmoscopy revealed small, elevated optic discs with blurry margins in both eyes (A, B) and peripapillary subretinal (B, white arrow) and intraretinal splinters (B, black arrow) and preretinal vitreous hemorrhage in the left eye. Enhanced-depth-imaging ocular coherence tomography demonstrated bilateral buried optic nerve drusen (OND) (C, left eye, white arrow). Intravenous fluorescein angiography did not show a peripapillary choroidal neovascular membrane (E). OND can rarely cause peripapillary hemorrhage affecting all retinal layers due to presumed vessel erosion by OND compression. Ophthalmologists should be aware that OND can be associated with concentric peripapillary hemorrhage. Recognition of OND and its complications avoids invasive testing for presumed papilledema.
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