Optic nerve head drusen and pseudotumor cerebri
B. Katz, P. Van Patten, J. F. Rothrock and R. Katzman
Department of Ophthalmology, University of California, San Diego, La Jolla 92093.
A 42-year-old woman presented with a history of headache. Results of
funduscopic examination revealed elevated disc margins and bilateral optic
nerve head drusen. Lumbar puncture, head computed tomography, and
fluorescein fundus angiography results were consistent with the diagnosis
of pseudotumor cerebri and coexistent disc drusen. Visual loss was
demonstrated by formal perimetry. Headaches were unresponsive to a medical
regimen that included prednisone, glycerol, acetazolamide, furosemide, and
repeated lumbar punctures. A lumbar peritoneal shunt was performed, with
immediate resolution of headache. Optic disc drusen can be associated with
pseudotumor cerebri and can lead to diagnostic confusion.