Optic disc drusen (ODD) is an acellular deposit located in front of the cribriform of the optic disc. ODD has been much underdiagnosed due to few obvious clinical symptoms. These clinical symptoms are easily confused with optic disc edema caused by systemic high-risk diseases. The current mainstream view is that optic nerve fiber axon metabolism is disordered, leading to intracellular mitochondrial calcification. After axon chronic disintegration, calcified mitochondria continuously release outside the cell, resulting in a much higher concentration of extracellular calcium than inside the cell. The continuous deposit and accumulation of extracellular calcification fuse to small calcified corpuscles, which lead to ODD formation. OCT enhanced deep imaging can detect ODD sensitively, and its image feature is a weak reflection core completely or partially surrounded by a strong reflection edge. ODD is one of the common causes for optic disc crowding. During adolescence, the accumulating calcified bodies buried in the deep optic disc gradually extrude and migrate to the superficial optic disc, which turn into superficial ODD. As a consequence, part of these ODD patients rapidly progress during adolescence and generally become stable in adulthood with anterior ischemic optic neuropathy, or other vascular complications.
