Optic disc drusen with subretinal hemorrhage

PurposeTo report a rare and interesting case of optic disc drusen with subretinal hemorrhage.SettingThe hemorrhagic complications of the optic disk drusen are rare and interesting.MethodsA 25 year old white man complained of an acute blurred vision in his left eye over the past 6 days. Visual acuity in the right eye was 20/20 and in the left eye 20/200. He had photoreactive and anisocoric pupils (left > right). Fundus examination in both eyes showed an elevated optic nerve head with blurred and irregular disc margins. In the left eye was present a subretinal hemorrhage.ResultsThe neurological examination and brain computed tomography were normal. Fluorescein angiography (FA) of the left eye showed hypofluorescence (blocked) due to subretinal hemorrhage. No fundus autofluorescence was detected. Indocyanine green angiography was performed to exclude a neovascular choroidal membrane. Goldmann visual field exam showed in the right eye enlargement of the blind spot and paracentral scotoma and in the left eye a small constriction of the isopters and central scotoma. Ocular ultrasound demonstrates an echogenic focus within the optic nerve head. No treatment was performed. Spontaneous resolution of the subretinal hemorrhage was observed. At 3‐months follow‐up the visual acuity of the right eye was 20/20 and left eye 20/25.ConclusionsOptic disc drusen may be associated with subretinal hemorrhage as a result of direct mechanical compression and rupture of subretinal vessels at the optic disc. Optic disc drusen often mimic papilledema and must be distinguished from true papilledema. The subretinal hemorrhage can resolve spontaneously.