(BMJ)—A 25-yo woman was referred to the ED by an optometrist for abnormal optic discs. She saw the optometrist to update her eyeglass Rx. She denied headache, nausea/vomiting, vision changes, or other neurological sx. Visual acuity: 20/20 bilat w/ full visual fields by confrontation. Fundi as shown. What is the dx?
Pseudotumor cerebri
Optic disc hemorrhage
Optic disc drusen
Optic neuritis
Bilateral retrobulbar masses
You are correct. Optic disc drusen (ODD) are a common cause of pseudopapilledema and may result in blurred optic disc margins, leading to an incorrect dx of papilledema. Because ODD are composed of small proteinaceous materials that become calcified, they are often visible on CT scans performed to rule out intracranial mass in an emergency situation. Dx is established by fundus autofluorescence, optical coherence tomography, or B-scan ultrasound. ODD do not typically result in vision loss, but rarely, visual field defects may develop and occur over time, due to progressive thinning of the retinal nerve fiber layer.

Emergency Medicine Journal 2019;36:534-553.
By vgreene, 16 January, 2020
By vgreene, 16 January, 2020