P 328
Frequency, severity and location of visual field loss in 120 eyes with optic disc drusen
A. E. Mantel, E. Gramer
Purpose: To evaluate retrospectively frequency, severity and topography of visual field loss in patients with optic disc drusen.
Methods: In 120 eyes (66 patients) with sonographically verified optic disc drusen visual field was examined with the octopus perimeter (500EZ or 201) and with the Goldmann perimeter. Visual field loss was classified in 4 stages: I: relative scotomas, II: spotlike absolute scotomas without connection to the blind spot, III: absolute scotomas connected to the blind spot, IV: extensive ablolute scotomas affecting at least two quadrants in the paracentral visual field, leaving a central island.
Results: 74 of 120 eyes (61,7 % ) with optic disc drusen showed a visual field loss: stage I was found in 47 eyes (63,1 %), stage II in 17 eyes (23,0 %), stage III in 2 eyes (2,7 %) and stage IV in 8 eyes (10,8 %). Scotomas were located in 24,5 % in the nasal upper, in 18,2 % in the temporal upper, in 35,0 % in the nasallower and in 22,4 % in the temporal lower quadrant. Out of 120 eyes optic disc drusen were bilateral in 102 eyes (77,3 %). In patients with bilateral optic disc drusen 47,1 % had a bilateral visual field loss, 23,5% had a unilateral visual field loss and 29,4% had no visual field loss. In patients with unilateral optic disc drusen 73,3 % had a visual field loss.
Conclusions: Visual field loss can be expected in more than half (61,7 %) of the eyes with optic disc drusen, often located in the nasal lower quadrant. Patients wlth bilateral optic disc drusen and those with unilateral optic disc drusen show no difference in the incidence of visual field loss but visual field loss in patients with bilateral optic disc drusen seems to be more severe. Due to the severity of visual field loss 3 of 24 patients with bilateral scotomas lost their abjlity of driving a car. Therefore perimetry and follow up is essential in patients with optic disc drusen.
University Eye Hospital, Josef-Schneider-Str. 11, D-97080 Würzburg, Germany