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Background:Arcuate visual field defects are a typical sign of glaucomatous damage.Elevated in traocular pressure in combination with pseudoexfoliatio n syndrome (PSX)manifests the diagnosis glaucoma.B eyond this state,in microdiscs with optic disc drusen,t he exact classifica-tion of the visual field defects is crucial.Case Report:A57-year-old male with pseudoexfoli ation glaucoma was referred because of progressive gla ucomatous visual field defects.The visual acuity was right 20/40and left 20/25.Maximum intraocular pressure was 36mm Hg.A simple optic nerve atrophy was diagnosed su peronasally.The optic disc size was OD 2.24mm 2 and OS 1.89mm 2 (HRT 1).An Ultrasound B-mode scan demonstr ated the diagnosis of optic disc drusen.Over a follow-up of 1year,a growth tendency was observed,especially in the superonasal quadrant.The mulberry-shaped surface of the drusen was visualized with infra red reflection im-ages(HRA II,830nm).Confocal scanning laser oph-thalmoscopy(HRA II,excitation 488nm,500nm notc h filter)showed an increased intrapapapilla ry autofluo-rescence(>50%papillary area:OD 1.67mm 2 ,OS1.26mm 2 ).This technique could detect drusen in areas that looked normal in classical reti noscopy.Conclusion:The differential diagnosis of arcuate scotomas includes simple optic nerve atrophy and glaucomatous optic nerve atrophy.Optic disc drusen in glauco ma eyes can obscure the main cause of progressive visual field loss.Superficial optic disc drusen can be measured pla nimetrically over the years.An adequate reduction of intr aocular pressure should be realized in these eyes.
Background: Arcuate visual field defects are a typical sign of glaucomatous damage. Elevated in traocular pressure in combination with pseudoexfoliatio n syndrome (PSX) manifests the diagnosis glaucoma. B eyond this state, in microdiscs with optic disc drusen, t he exact classifica- tion of the visual field defects is crucial. Case Report: A57-year-old male with pseudoexfoli a glaucoma was referred because of progressive glaucomatous visual field defects. visual acuity was right 20/40 and left 20 / 25. Maximum intraocular pressure was 36mm Hg. A simple optic nerve atrophy was diagnosed su peronasally. The optic disc size was OD 2.24 mm 2 and OS 1.89 mm 2 (HRT 1). An Ultrasound B-mode scan demonstr ated the diagnosis of optic disc drusen. Over a follow- up of 1year, a growth tendency was observed, especially in the superonasal quadrant. The mulberry-shaped surface of the drusen was visualized with infra red reflection im-ages (HRA II, 830nm) .Confocal scanning laser oph-thalmoscopy (HRA II, excitation 488n 500 nm notc h filter) showed an increased intrapapapilla ry autofluo-rescence (> 50% papillary area: OD 1.67 mm 2, OS 1.26 mm 2). This technique could detect drusen in areas that looked normal in classical reti noscopy. Confclusion: The differential diagnosis of arcuate scotomas includes simple optic nerve atrophy and glaucomatous optic nerve atrophy. Optic disc drusen in glauco ma eyes can obscure the main cause of progressive visual field loss. Superficial optic disc drusen can be measured pla nimetrically over the years. reduction of intr aocular pressure should be realized in these eyes.