Much of the discussion in this chapter deals with optic disc drusen. Disc drusen are more common in Caucasian patients and are composed of small conglomerates of mucopolysaccharides and proteinaceous material that become calcified with advancing age. They may be inherited as an autosomal trait with irregular penetrance and also may be associated with retinitis pigmentosa. Drusen are believed to be less common in African American patients. No sexual predilection exists.
Most patients are asymptomatic.
Visual symptoms Usually no visual symptoms are present. A minority of patients with disc drusen experience transient visual flickering or graying-out that is similar to what sometimes is seen in patients with papilledema. Rarely, patients also might experience more permanent visual loss from secondary processes. For example, disc drusen probably increase the risk of later developing subretinal neovascular membranes or retinal vascular occlusion. A patient who has disc drusen eventually may lose central acuity.