Journal List > J Korean Ophthalmol Soc > v.60(12) > 1139609

J Korean Ophthalmol Soc. 2019 Dec;60(12):1369-1373. Korean.
Published online Dec 17, 2019.
©2019 The Korean Ophthalmological Society
Anti-Vascular Endothelial Growth Factor Therapy for Choroidal Neovascularization Secondary to Optic Nerve Head Drusen
Ka Hee Park, MD
Nune Eye Hospital, Seoul, Korea.

Address reprint requests to Ka Hee Park, MD. Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 06198, Korea. Tel: 82-2-2086-7750, Fax: 82-2-2086-7710, Email:
Received Jun 16, 2019; Revised Oct 24, 2019; Accepted Dec 06, 2019.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



To describe a patient with optic nerve head drusen who showed improved retinal hemorrhage and visual acuity following intravitreal anti-vascular endothelial growth factor (bevacizumab) injection.

Case summary

A 53-year-old woman with no underlying disease presented with sudden vision loss in her left eye. Her best-corrected visual acuity was 1.0 in the right eye and 0.8 in the left eye; the intraocular pressure was 15 mmHg in both eyes. Anterior segment examination revealed no abnormal findings. Fundus examination showed subretinal hemorrhage and serous retinal detachment in the left eye. Fluorescein angiography and indocyanine green fundus examination revealed hyperfluorescence near the optic disc. The patient was diagnosed with choroidal neovascularization of the left eye secondary to optic nerve head drusen; intravitreal bevacizumab injection was then performed. Three weeks later, the patient showed improved retinal hemorrhage.


Intravitreal anti-vascular endothelial growth factor injection may be an effective treatment for choroidal neovascularization associated with optic nerve head drusen.

Keywords: Anti-vascular endothelial growth factor; Bevacizumab; Choroidal neovascularization; Intravitreal injection; Optic nerve head drusen


Figure 1
Visual field tests of both eyes at the first visit.
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Figure 2
Fundus photography of both eyes. (A) Pre-treatment and (B) post-treatment fundus photography at 3 weeks after intravitrealbevacizumab injection.
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Figure 3
Optical coherence tomography(OCT) and retinal angiograms of the lefteye. (A) A hyperreflective subretinal masslikelesion (white arrow) is buried at opticdisc and subretinal fluid extended fromthe optic nerve head to the macula andpigment epithelial detachment (blue arrow)is observed on OCT. (B) Fluoresceinand Indocyanine green angiogram revealedround small hyperfluorescencewithin the hypofluorescence area of subretinalhemorrhage.
Click for larger image


Conflicts of Interest:The authors have no conflicts to disclose.

1. Auw-Haedrich C, Staubach F, Witschel H. Optic disk drusen. Surv Ophthalmol 2002;47:515–532.
2. Palmer E, Gale J, Crowston JG, Wells AP. Optic nerve head drusen: an update. Neuroophthalmology 2018;42:367–384.
3. Romero J, Sowka J, Shechtman D. Hemorrhagic complications of optic disc drusen and available treatment options. Optometry 2008;79:496–500.
4. Kurz-Levin MM, Landau K. A comparison of imaging techniques for diagnosing drusen of the optic nerve head. Arch Ophthalmol 1999;117:1045–1049.
5. Lee KM, Woo SJ, Hwang JM. Differentiation of optic nerve head drusen and optic disc edema with spectral-domain optical coherence tomography. Ophthalmology 2011;118:971–977.
6. Seo DR, Park SH. Optical coherence tomography findings of optic nerve head drusen in children and adolescents. J Korean Ophthalmol Soc 2015;56:1446–1453.
7. Grippo TM, Shihadeh WA, Schargus M, et al. Optic nerve head drusen and visual field loss in normotensive and hypertensive eyes. J Glaucoma 2008;17:100–104.
8. Choi WG, Jang JH. A case of optic disc hemorrhage associated with buried optic disc nerve head drusen. J Korean Ophthalmol Soc 2014;55:1099–1105.
9. Duncan JE, Freedman SF, El-Dairi MA. The incidence of neovascular membranes and visual field defects from optic nerve head drusen in children. J AAPOS 2016;20:44–48.
10. Delyfer MN, Rougier MB, Fourmaux E, et al. Laser photocoagulation for choroidal neovascular membrane associated with optic disc drusen. Acta Ophthalmol Scand 2004;82:236–238.
11. Silva R, Torrent T, Loureiro R, et al. Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin. Eur J Ophthalmol 2004;14:434–437.
12. Mateo C, Moreno JG, Lechuga M, et al. Surgical removal of peripapillary choroidal neovascularization associated with optic nerve drusen. Retina 2004;24:739–745.
13. Knape RM, Zavaleta EM, Clark CL 3rd, et al. Intravitreal bevacizumab treatment of bilateral peripapillary choroidal neovascularization from optic nerve head drusen. J AAPOS 2011;15:87–90.
14. Delas B, Almudí L, Carreras A, Asaad M. Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy. Clin Ophthalmol 2012;6:225–230.
15. Saffra NA, Reinherz BJ. Peripapillary choroidal neovascularization associated with optic nerve head drusen treated with anti-VEGF agents. Case Rep Ophthalmol 2015;6:51–55.