The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 4, July/August 2018 Review Article

The Role of Optical Coherence Tomography in Differentiating Optic Disc Drusen from Optic Disc Edema

Costello, Fiona; Malmqvist, Lasse; Hamann, Steffen

Author Information

From the *Departments of Surgery and †Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; and ‡Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Reprints: Fiona Costello, MD, FRCP, Foothills Medical Centre, Clinical Neurosciences, 12th Floor 1403–29 Street NW, Calgary, Alberta, Canada T2N 2T9.


An elevated optic nerve head can be an ominous sign, sometimes signifying an underlying basis for raised intracranial pressure. Alternatively, patients may harbor a different mechanism for this optic nerve head appearance, including optic disc drusen (ODD), which does not confer any life-threatening implications. It is important to refine the approach to distinguishing ODD from papilledema because this is a relatively common, and important, conundrum encountered in clinical practice. Optical coherence tomography (OCT) is a noninvasive, readily accessible, and cost-effective ocular imaging technique that can improve the diagnostic accuracy for detecting ODD; or, instead, increase the index of suspicion for papilledema, thus prompting additional investigations needed to identify (or exclude) potential causes of raised intracranial pressure. In this review, we will discuss the value of OCT in the diagnostic approach to cases of mild optic disc elevation, with acknowledgment of the potential pearls and pitfalls of this imaging technology. In particular, we will emphasize the helpful role OCT can play in differentiating cases of ODD from mild papilledema in the context of idiopathic intracranial hypertension (IIH).

Full Text

View PDF Online

Download PDF

APJO Express

More About APAO

  • 1
  • 2
  • 3
  • 4
< >
All Rights Reserved © Asia-Pacific Academy of Ophthalmology