Hemorrhagic complications of optic disc drusen and available treatment options

BackgroundOptic disc drusen typically are considered benign findings. However, optic disc drusen can manifest with hemorrhagic complications.Case ReportA dilated fundus examination on a 27-year-old visually asymptomatic optometry student found a juxtapapillary hemorrhage one quarter of a disc diameter in size in the right eye, immediately off the superior nasal aspect of the disc. Bilateral disc drusen, confirmed by hyperreflectivity on ultrasonography, were also noted. Fluorescein angiography and optical coherence tomography were diagnostic only for a deep isolated intra- and subretinal hemorrhage. Neither diagnostic modality could confirm the presence or absence of a choroidal neovascular membrane. Because of the asymptomatic nature, location of the hemorrhage, and lack of conclusive etiology, close monitoring was recommended. After 4 months, 75% of the hemorrhage had reabsorbed with no visual complications.ConclusionsOptic disc drusen can cause ocular hemorrhages through several mechanisms. Although many are benign and self-limiting, it is important to understand available treatment modalities should vision be threatened.