[Hemorrhagic complications of drusen of the optic disk].

Introduction: The hemorrhagic complications of the optic disk drusen are rare and interesting because of their functional implications, the difficulty of the differential diagnosis and the uncertain pathogeny.
Material: and methods: Retrospective study of 6 cases with a complete general and ophthalmological examination, followed between 2 and 9 years.
Results: The average age of the cases was 38.5 years (9-62 years). The visual acuity was slightly affected and reversible in the papillary hemorrhages (1 case), low and partial reversible in the extended hemorrhages (4 cases), severe affected and irreversible in the associations with a choroidal neovascular membrane with macular implications (1 case). We found three types of hemorrhages: papillary (1 case), peripapillary associated with choroidal neovascular membrane in acute (2 cases) and cicatricial stage (1 case), extended subretinal (2 cases). The papillary drusen were profound (4 cases) and superficial (2 cases). Ultrasonography showed the presence of the optic disk drusen in both eyes in all cases. The evolution followed on a period from 2 to 9 years, revealed the resorbtion of the hemorrhages between 3 and 6 months, the reversible visual acuity in the cases without macular implication, and the absence of recidiva or bilateralisation.
Discussions and Conclusions: The authors are presenting a number of clinical cases of papillary drusen complicated with hemorrhages, some of the cases being associated with choroidial neovascular membrane. Because of the clinical appearance, aspects of differential diagnosis with papillary edema of other etiologies are discussed. A role in the pathogeny is attributed to the direct or progressive compression of the retinal vascularisation which can provoke the erosion of the vessels and in some cases the appearance of the choroidal neovascular membrane. The suggested therapy is medical, surgical, or by photocoagulation, but the results are contradictory.