Optic Nerve Drusen - Mild - Also Macular Pucker
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74-year-old woman has macular edema in both eyes. She also has macular puckers. She has responded nicely in the past to posterior sub-Tenon Kenalog injections and she has not had one in her right eye now since February. Her left eye was last treated in July. She has noticed the vision in the right eye declining over last few weeks.
VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 10, OS 12. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is 1+ optic nerve drusen and 2+ epiretinal membrane.
OS: Vertical C/D ratio is 0.1. There is 1+ optic nerve drusen and 2+ epiretinal membrane.
SPECTRALIS-SD-OCT SCAN: The nerve fiber layer thickness was normal in each eye. The macular thickness is more swollen in the right eye than the left eye. The point thickness in the right eye is 582 microns and the left eye has 407 microns. The scans do show the epiretinal membranes in each eye.
FUNDUS AUTO FLUORESCENCE: Auto fluorescence images show the optic nerve drusen.
IMPRESSION:
1. MACULAR PUCKERS – BOTH EYES
2. CHRONIC MACULAR EDEMA – BOTH EYES
3. OPTIC NERVE DRUSEN – BOTH EYES
DISCUSSION: I explained to the patient with a posterior sub-Tenon Kenalog injection behind the left eye, there is a reasonable chance of improving her visual acuity.
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Optic Nerve Drusen Both Eyes (Mild) 556 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40. 
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Optic Nerve Drusen Both Eyes (Mild) 533 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40.
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Optic Nerve Drusen Both Eyes (Mild) 627 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40. 
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Optic Nerve Drusen Both Eyes (Mild) Fundus Autofluorescence546 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40.
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Optic Nerve Drusen Both Eyes (Mild) Fundus Autofluorescence659 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40.
(1 votes)
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Optic Nerve Drusen Both Eyes (Mild) Nerve Fiber Layer Scan490 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40.
(0 votes)
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Optic Nerve Drusen Both Eyes (Mild) Nerve Fiber Layer Scan461 views74-year-old woman has macular edema in both eyes. She also has macular puckers. OD 20/30, OS 20/40.
(0 votes)
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74-year-old woman has macular edema in both eyes. She also has macular puckers. She has responded nicely in the past to posterior sub-Tenon Kenalog injections and she has not had one in her right eye now since February. Her left eye was last treated in July. She has noticed the vision in the right eye declining over last few weeks.
VISUAL ACUITY: OD 20/30, OS 20/40. IOP: OD 10, OS 12. The posterior chamber intraocular lens is in good position in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is 1+ optic nerve drusen and 2+ epiretinal membrane.
OS: Vertical C/D ratio is 0.1. There is 1+ optic nerve drusen and 2+ epiretinal membrane.
SPECTRALIS-SD-OCT SCAN: The nerve fiber layer thickness was normal in each eye. The macular thickness is more swollen in the right eye than the left eye. The point thickness in the right eye is 582 microns and the left eye has 407 microns. The scans do show the epiretinal membranes in each eye.
FUNDUS AUTO FLUORESCENCE: Auto fluorescence images show the optic nerve drusen.
IMPRESSION:
1. MACULAR PUCKERS – BOTH EYES
2. CHRONIC MACULAR EDEMA – BOTH EYES
3. OPTIC NERVE DRUSEN – BOTH EYES
DISCUSSION: I explained to the patient with a posterior sub-Tenon Kenalog injection behind the left eye, there is a reasonable chance of improving her visual acuity.
