Symptoms: mostly asymptomatic, but may present with visual field defects, decreased visual acuity, or transient obscuration of vision.
Signs:
Discrete, multiple, amorphous or partly calcified hyaline bodies located anterior to the lamina cribrosa
The bodies may be superficial or buried within the optic disc (typically in the nasal region)
Buried hyaline bodies in children or young people may simulate papilledema
Superficial drusen appear as autofluorescent bodies that are visible on fundus photographs using appropriate filter prior to fluorescein dye injection
As the progression of the drusen interferes with the blood supply of the optic nerve, several conditions may result:
Acute swelling of the optic nerve
Splinter hemorrhage
Ischemic optic neuropathy
Fluoresecein angiography:
Undilated capillary network with no leakage of dye into the peripapillary region.
Discrete foci of hyperfluorescence with late staining of the drusen.
B-scan ultrasound is helpful in detecting buried drusen.
Associated ocular findings include Retinits Pigmentosa, angioid streaks in patients with or whithout pseudoxanthoma elasticum, Usher's syndrome and X-linked retinoschisis.