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March 1977

The Pathogenesis of Optic Nerve Drusen: A Hypothesis

Author Affiliations

From the Departments of Ophthalmology (Drs Sacks and O'Grady and Mr Choromokos), Neurology (Drs Sacks and Leestma), and Pathology (Dr Leestma), Northwestern University Medical School, Chicago.

Arch Ophthalmol. 1977;95(3):425-428. doi:10.1001/archopht.1977.04450030067005

• Myriads of tiny perivascular drusen were found at histologic examination of the eyes of a 19-year-old patient who had pseudopapilledema and who died of a ruptured intracranial aneurysm. The possibility that they arose from constituents leaking from abnormal blood vessels prompted a review of 53 fluorescein retinal angiograms of patients with optic nerve drusen. As compared to a control group, many of these angiograms revealed the following abnormalities: (1) an abnormal branching pattern on the disc; (2) the presence of relatively large blood vessels connecting the superficial and deep disc circulations; and (3) Increased disc capillarity. We believe that the tendency to develop optic nerve drusen results, at least in part, from a congenitally abnormal disc vasculature that allows transudation of plasma proteins that in turn serve as a nidus for the deposition of extracellular materials.

(Arch Ophthalmol 95:425-428, 1977)

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