Researchers recently observed demarcation of buried optic disc drusen (ODD) from the optic nerve axons on en face OCT and poor vascular perfusion of buried ODD on OCT angiography (OCT-A), suggesting that buried ODD are deposited around the optic disc rather than the herniated optic nerve axon fibers.

This retrospective, cross-sectional study evaluated the medical records of 61 patients (92 eyes) with buried ODD, 45 patients (62 eyes) with optic disc edema and 42 normal-appearing fellow eyes. 

On en face OCT, the investigators found that buried ODD appeared as hyper-reflective, kidney-shaped masses well demarcated from the optic nerve axons; optic disc edema, however, appeared as ill-defined boundaries confluent with the retinal nerve fibers. On OCT-A, they noted that 25.0% of eyes with buried ODD showed a C-shaped vessel density decrease in the nasal radial peripapillary capillary layer, while 40.3% of eyes with optic disc edema had non-specific focal vessel density decrease around the optic nerve head. 

The study authors added that larger buried ODD were significantly associated with a vessel density decrease on OCT-A. They also discovered that the disc diameter positively correlated with the buried ODD area and negatively correlated with the buried ODD height.