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Drusen, from the German word for node or geode (singular, "Druse"), are tiny yellow or white accumulations of extracellular material that build up between Bruch's membrane and the retinal pigment epithelium of the eye. The presence of a few small ("hard") drusen is normal with advancing age, and most people over 40 have some hard drusen. [1]
Pain, visual loss, relapse, and steroid response are typical of CRION. [1] [3] Ocular pain is typical, although there are some cases with no reported pain. [3]Bilateral severe visual loss (simultaneous or sequential) usually occurs, but there are reports of unilateral visual loss. [3]
These include general surgical procedures, cataract surgery, hemorrhagic shock, certain medications, and optic disc drusen. The exact mechanism of optic nerve ischemia in these cases remains unclear, but contributing factors may include hypotension , anemia , hypoxia , and changes in the autoregulation of optic nerve arterial blood flow.
Some sufferers (10–15%) report various pains growing in severity with progression of the disease. [1] The nerves most commonly affected are the peroneal nerve at the fibular head (leg and feet), the ulnar nerve at the elbow (arm) and the median nerve at the wrist (palm, thumbs and fingers), but any peripheral nerve can be affected.
In children, optic disc drusen are usually buried and undetectable by fundoscopy except for a mild or moderate elevation of the optic disc. With age, the overlying axons become atrophied and the drusen become exposed and more visible. They may become apparent with an ophthalmoscope and some visual field loss at the end of adolescence. [7]
Foot drop can be managed with ankle-foot orthoses or surgical tendon transfer, [8] in which the tibialis posterior muscle is repurposed to function as a tibialis anterior muscle. In select types of distal myopathy, evaluation of the heart may be indicated. [8] Scoliosis and contractures can be surgically managed. [8]
North Carolina macular dystrophy is an extremely rare autosomal dominant genetic disorder that primarily affects the eyes. It is a non-progressive disorder which is characterized by an abnormal development of the macula, multiple drusen, photoreceptor cells atrophy, and central vision loss. [2]
Diabetic foot conditions can be acute or chronic complications of diabetes. [1] Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. The resulting bone deformity is known as Charcot foot.