Pseudopapilledema Treatment & Management
- Author: Mitchell V Gossman, MD; Chief Editor: Hampton Roy, Sr, MD more...
No treatment is needed for most causes of pseudopapilledema because they represent normal physiologic variants.
Diseases possibly associated with disc drusen may need treatment, such as subretinal neovascular membrane, central retinal vein occlusion, or ischemic optic neuropathy (largely to exclude giant cell arteritis in the appropriate age groups).
A minority of patients with disc drusen (16-22%) present with progressive visual loss. Field deterioration normally occurs over many years and is generally slow and unnoticed by patients. Dramatic field loss related to vascular complications, such as anterior ischemic optic neuropathy, can rarely occur. Unfortunately, no successful therapy is available at this time.
For patients who may suffer from glaucoma, it can be challenging to differentiate progressive glaucomatous field loss from field loss due to glaucoma. Estimation of the cup-to-disc ratio is also more challenging.
No effective surgical treatment is available.
Sato T, Mrejen S, Spaide RF. Multimodal Imaging of Optic Disc Drusen. Am J Ophthalmol. 2013 May 12. [Medline].
Merchant KY, Su D, Park SC, Qayum S, Banik R, Liebmann JM, et al. Enhanced Depth Imaging Optical Coherence Tomography of Optic Nerve Head Drusen. Ophthalmology. 2013 Mar 23. [Medline].
Lee KM, Woo SJ, Hwang JM. Morphologic characteristics of optic nerve head drusen on spectral-domain optical coherence tomography. Am J Ophthalmol. 2013 Jun. 155(6):1139-1147.e1. [Medline].
Grippo TM, Shihadeh WA, Schargus M, Gramer E, Tello C, Liebmann JM, et al. Optic nerve head drusen and visual field loss in normotensive and hypertensive eyes. J Glaucoma. 2008 Mar. 17(2):100-4. [Medline].
Acheson JF, Sanders MD. Common Problems in Neuro-ophthalmology. 1997. 78-84.
Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol. 2002 Nov-Dec. 47(6):515-32. [Medline].
Cullom RD, Chang B. The Wills Eye Manual. 1994. 270-272.
Kline LB. Optic Nerve Disorders. 1996. 37-53.
Miller NR, Newman NJ. Clinical Neuro-Ophthalmology - The Essentials. 1999. 166-195.
Vaphiades MS. The disk edema dilemma. Surv Ophthalmol. 2002 Mar-Apr. 47(2):183-8. [Medline].
Yanoff M, Duker JS. Ophthalmology. 1999. 11.5.1-5.4.
Asensio-Sánchez VM, Trujillo-Guzmán L. SD-OCT to distinguish papilledema from pseudopapilledema. Arch Soc Esp Oftalmol. 2015 Oct. 90 (10):481-483. [Medline].