Clinical Report: Prelaminar Hyperreflective Lines in NAION

Overview

This retrospective study examined OCT-defined optic disc drusen (ODD) or hyperreflective lines (HRLs) in patients with non-arteritic anterior ischaemic optic neuropathy (NAION). Among 177 NAION patients, 42 with ODD-like features involving 58 eyes were identified and compared with 45 patients without these features, involving 66 eyes; the supplied article text does not include the study’s outcome results.

Background

ODD are calcified deposits anterior to the lamina cribrosa and are associated with crowded optic discs; the source estimates their prevalence at approximately 2% of the general population. ODD have been associated with visual field defects and, in some patients, vascular complications including NAION. NAION is described as the predominant ischaemic optic neuropathy in adults older than 50 years and is associated with vascular risk factors such as diabetes, hypertension, and hyperlipidaemia. HRLs on enhanced-depth imaging OCT have been proposed as an early manifestation of ODD, but their clinical significance in NAION remains uncertain.

Data Highlights

Key Findings

• ODD-like features were defined as ODD or HRLs identified on enhanced-depth imaging OCT.
• The ODD-like-feature group comprised 42 patients and 58 eyes; the comparison group comprised 45 patients and 66 eyes.
• Eyes with prominent ODD were classified as ODD-AION when at least one druse measured ≥100 µm in its largest dimension.
• HRL-AION eyes had at least one HRL and no ODD measuring ≥100 µm; eyes with a smaller ODD could remain in this group.
• Enhanced-depth imaging OCT was used to identify ODD and HRLs, with 97-line horizontal and 6-line radial scans of the optic nerve.
• The supplied article excerpt describes the study rationale and methods but does not provide comparative clinical, imaging, or outcome results.

Clinical Implications

The study’s methods distinguish prominent ODD from HRL-only or small-ODD eyes using OCT findings and a 100-µm size threshold. Because the supplied excerpt does not report the comparative results, it does not support conclusions about visual outcomes or the prognostic significance of HRLs in NAION.

Conclusion

The article describes a retrospective comparison of NAION eyes with and without ODD-like OCT features. The available source material is insufficient to report the study’s outcome findings.

Related Resources & Content

1. Prelaminar hyperreflective lines in non-arteritic anterior ischaemic optic neuropathy, Eye, 2026
2. Optic Disc Drusen Studies Consortium, PubMed, 2018 -- The Optic Disc Drusen Studies Consortium Recommendations for Diagnosis of Optic Disc Drusen Using Optical Coherence Tomography
3. Copenhagen Child Cohort 2000 Eye Study, PubMed, 2020 -- Progression Over 5 Years of Prelaminar Hyperreflective Lines to Optic Disc Drusen
4. Punjabi OS, Tanna AP, Rosenberg MA, Retinal Physician, 2010 -- Nonarteritic Anterior Ischemic Optic Neuropathy: Its Clinical Features, Diagnosis and Treatment
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13. Progression Over 5 Years of Prelaminar Hyperreflective Lines to Optic Disc Drusen in the Copenhagen Child Cohort 2000 Eye Study.
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