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72-year-old woman was seen in the office on January 4, 2012. She comes to this area for most winters, but recently she has decided to see her medical doctors down here. Where she lives up north she is more rural and does not have much access or it is a long drive to see someone. You saw her for the first time recently and suggest she come here because of her macular puckers. She has had optic nerve drusen for sometime and has visual fields followed for that and she has had her cataracts removed. VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 17, OS 20. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The left eye has an open capsule. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is drusen on the optic nerve. There is a posterior vitreous separation and 2+ epiretinal membrane. OS: Vertical C/D ratio is 0.0. There is drusen on the optic nerve. There is a posterior vitreous separation and 2+ epiretinal membrane. SPECTRALIS-SD-OCT SCAN: The nerve fiber layer scan showed atrophy with the average thickness in the right eye being 68 microns and the average thickness in the left eye being 56 microns. The macular scans show only minimal elevation of the fovea from the macular puckers in both eyes. FUNDUS AUTO FLUORESCENCE: The auto fluorescence images show hyper auto fluorescence of the nerve drusen in both eyes. The macular auto fluorescence pattern is nearly normal. IMPRESSION: 1. MACULAR PUCKER – BOTH EYES 2. OPTIC NERVE DRUSEN – BOTH EYES WITH NERVE FIBER LAYER ATROPHY DISCUSSION: I explained to the patient she does have macular puckers, but they don’t look to be adversely affecting her visual acuity and they rarely progress. She has moderate optic atrophy from her optic nerve drusen and I think that does need to be followed.

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Optic Nerve Drusen - - Fundus Autofluorescence - FAF429 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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Optic Nerve Drusen - Fundus Autofluorescence - FAF348 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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Optic Nerve Drusen - Line Scan over Optic Nerve541 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenod_moma04.png
Optic Nerve Drusen - - Nerve Fiber Layer Scan270 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenod_moma05.png
Optic Nerve Drusen - - Nerve Fiber Layer Scan416 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenos_moma06.png
Optic Nerve Drusen - - Fundus Autofluorescence - FAF526 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenos_moma07.png
Optic Nerve Drusen - Line Scan over Optic Nerve710 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenos_moma08.png
Optic Nerve Drusen - - Nerve Fiber Layer Scan389 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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ondrusenos_moma09.png
Optic Nerve Drusen - Nerve Fiber Layer Scan372 views72-year-old woman has had optic nerve drusen for sometime and has visual field abnormalities. OD 20/32, OS 20/32. 00000
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72-year-old woman was seen in the office on January 4, 2012. She comes to this area for most winters, but recently she has decided to see her medical doctors down here. Where she lives up north she is more rural and does not have much access or it is a long drive to see someone. You saw her for the first time recently and suggest she come here because of her macular puckers. She has had optic nerve drusen for sometime and has visual fields followed for that and she has had her cataracts removed. VISUAL ACUITY: OD 20/32, OS 20/32. IOP: OD 17, OS 20. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The left eye has an open capsule. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is drusen on the optic nerve. There is a posterior vitreous separation and 2+ epiretinal membrane. OS: Vertical C/D ratio is 0.0. There is drusen on the optic nerve. There is a posterior vitreous separation and 2+ epiretinal membrane. SPECTRALIS-SD-OCT SCAN: The nerve fiber layer scan showed atrophy with the average thickness in the right eye being 68 microns and the average thickness in the left eye being 56 microns. The macular scans show only minimal elevation of the fovea from the macular puckers in both eyes. FUNDUS AUTO FLUORESCENCE: The auto fluorescence images show hyper auto fluorescence of the nerve drusen in both eyes. The macular auto fluorescence pattern is nearly normal. IMPRESSION: 1. MACULAR PUCKER – BOTH EYES 2. OPTIC NERVE DRUSEN – BOTH EYES WITH NERVE FIBER LAYER ATROPHY DISCUSSION: I explained to the patient she does have macular puckers, but they don’t look to be adversely affecting her visual acuity and they rarely progress. She has moderate optic atrophy from her optic nerve drusen and I think that does need to be followed.