Optic Nerve Head Drusen, Myopia and Ocular Hypertension: A Case Report

A 20-year-old male patient presented at our clinic complaining of strange visual experiences (neither decreased nor blurred) and a mild headache while reading. His best corrected visual acuity revealed 20/20 with a fort myopic correction. Intraocular pressures measured with Dynamic Contour Tonometer (DCT) (Swiss Microtechnology AG, Port, Switzerland) were 23.3 mmHg in the right eye (OD) and 27.4 mmHg in the left eye (OS) with central corneal thicknesses (CCTs) of 588 (OD) and 591 (OS) microns, respectively. Optic discs were bilateral pale with indistinct and scalloped margins without cupping. Red free photos showed autofluorescence of both optic discs, representative of optic disc drusen. Visual field analysis (VFA) of both eyes revealed sensitivity depression with localized defects consistent with the Optical Coherence Tomography (OCT) findings. Optic nerve head drusen (ONHD), myopia and high intraocular pressures (IOPs), may cause ganglion cell damage resulting in RNFL thinning and visual field loss. Because of the difficulty in detecting the exact cause and the extent of the damage, patients with ONHD associated with high IOPs and myopia should be examined closely with serial monitoring using OCT and VFA. In case of RNFL thinning and visual field defects, topical antiglaucomatous therapy should also be determined.