A 12-year-old boy referred for 'papilloedema' has elevated-looking discs with blurred margins but normal visual acuity, no headache, and no venous pulsation abnormality. Autofluorescence imaging shows discrete hyperautofluorescent nodules within the discs, and B-scan ultrasound reveals echogenic foci with shadowing. The most likely diagnosis is:
- A Papillitis
- B Idiopathic intracranial hypertension
- C Optic disc drusen ✓
- D Optic nerve glioma
Correct answer: C. Optic disc drusen
Explanation
Optic disc drusen are calcified hyaline bodies that produce pseudopapilloedema: elevated, blurred discs without true swelling. Buried drusen are confirmed by autofluorescence showing hyperfluorescent nodules and by B-scan ultrasound showing echogenic foci behind the disc with acoustic shadowing. Vision is usually normal, and there are no symptoms of raised intracranial pressure, which excludes idiopathic intracranial hypertension. Papillitis causes acute visual loss and an RAPD, neither present here.
Reference: Kanski's Clinical Ophthalmology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.