Pediatric optic disc drusen tied to narrow scleral canal

This population-based study assessed the prevalence of optic disc drusen (ODD) among children and explored whether ODD is associated with scleral canal diameter or fetal birth and pubertal parameters.

Study design

This observational, longitudinal population-based birth cohort study, with a nested case-control, included 1,406 children. Eye examinations were performed when the children were between 11 and 12 years of age. Assessment was performed using optical coherence tomography (OCT) scans from 1,304 children with gradable enhanced depth imaging scans of the optic disc.

Outcomes

About 2.4% of the general population had ODD. In this study, ODD in one or both eyes were found in 13 (1.0%) of all children. All but 1 of the cases occurred in children with a scleral canal diameter in the lowest quartile. Children with ODD had a mean disc diameter of 1,339 micrometers, whereas the average disc diameter was 1,508 micrometers in 130 controls without ODD (P<0.001). No differences in sex, birth weight, refractive error or Tanner stages of puberty were found between groups.

Limitations

Despite the large number of patients in this study, only a small proportion of children had ODD.

Clinical significance

The prevalence of ODD was 1% in this large child cohort. This diagnosis was found only in eyes with a narrow scleral canal, consistent with the hypothesis that ODD stems from retinal nerve fiber congestion in the scleral canal.