we present the case of a young woman with optic disc drusen and peripheral vasculitis . diagnosis was based on fundoscopic , optical coherence tomography as well as fluorescein angiography ( fa ) findings . an asymptomatic 34-year - old female patient with no systemic pathology was referred to our hospital from her optician for retinal findings . fundoscopy revealed mild disc swelling that could be attributed to the presence of optic disc drusen in both eyes . in our case , the unique feature was the presence of optic disc drusen and retinal periphlebitis . the patient 's disc configuration may have contributed to a predisposition for vasculitis in addition to vessel tortuosity . small optic discs with abnormal vasculature have been shown to be predisposed to obstruction in axoplasmic flow . this may result in stasis , thus disrupting axonal metabolism . in these pathologic circumstances , calcium crystals are deposited into nerve cell mitochondria at first and then in the extracellular space . constant calcification as well as increase in size of these deposits gives rise to optic disc drusen . retinal vasculitis is a pathological entity that may potentially lead to blindness . in its active stage , exudates are observed around retinal vessels thus resulting in cuffing or white sheathing of the affected vessels . recurring vasculitic attacks eventually result in permanent vascular occlusion and tissue hypoxia , which in turn may cause neovascularization in the optic nerve head or elsewhere . we present the case of a young asymptomatic woman with optic disc drusen and vasculitis . a 34-year - old female patient was referred to our hospital from her optician for retinal findings . baseline visual acuity was 6/5 - 2 in the right eye and 6/5 in the left eye . fundoscopy in the right eye revealed vessel tortuosity and dot and blot haemorrhages in the periphery and in the mid periphery . there was also mild disc swelling that could be attributed to the presence of optic disc drusen ( fig . no inflammatory activity ( cells or vitreous haze ) , neovascularization or vitreous haemorrhage was observed in either eye . optical coherence tomography ( oct ) revealed the presence of optic disc drusen and normal fovea in both eyes ( fig . 2 ) . fluorescein angiography ( fa ) revealed marked leakage and venous sheathing from the peripheral and mid - peripheral veins in the right eye . extensive blood tests were carried out , including potassium , sodium , urea , creatinine , albumin , alkaline phosphatase , gamma - glutamyl transferase levels , c - reactive protein , esr , complete blood count , plasma viscosity and glomerular filtration rate . thrombin , partial thromboplastin time , haemoglobin , bilirubin as well as anticardiolipin antibodies , haemoglobinopathies and quantiferon gold tube tuberculosis tests were also ordered . we examined the patient 1 month later and there was no significant change in the patient 's overall condition . after 9 months visual acuity , fundoscopy , angiographic findings and oct images were unaltered . abnormal anatomic disc features such as small optic disc , tilted disc , and optic nerve drusen have been identified as discs at increased risk for several ophthalmic , neurological and vascular disorders . in the relevant literature , optic disc drusen have been associated with small , crowded discs which may be predisposed to axonal flow obstruction due to smaller than average scleral foramina . the presence of optic disc drusen and chronic venous stasis at the optic nerve head may also result in vessel tortuosity varying with the degree of disc crowding . oct has been recently shown to demonstrate and differentiate optic nerve drusen but is not yet considered a gold standard . the presence of optic disc drusen may be confirmed with optic nerve head ultrasound or fundus autofluorescence . in our case , venous stasis was observed in the right eye but not in the left eye . periphlebitis in the mid - periphery was also observed in the right eye but it did not affect visual acuity in this eye . signs of periphlebitis include gorged vessels , venous sheathing , localized ischaemia and haemorhage as well as vascular remodelling . despite extensive laboratory investigations , no clear aetiology was identified for this periphlebitis as all potential inflammatory causes were excluded . idiopathic periphlebitis represents 70 - 75% of the reported periphlebitis cases in the relevant literature . in rare occasions , optic disc drusen may be accompanied by vascular complications such as choroidal neovascularization . in this case , however , this possibly longstanding vasculitis did not require topical or systemic treatment . the unique feature of this case is the presence of optic disc drusen and retinal periphlebitis . the patient 's disc configuration may have contributed to a predisposition for vasculitis in addition to vessel tortuosity .
purposewe present the case of a young woman with optic disc drusen and peripheral vasculitis.methodsdiagnosis was based on fundoscopic , optical coherence tomography as well as fluorescein angiography ( fa ) findings.resultsan asymptomatic 34-year - old female patient with no systemic pathology was referred to our hospital from her optician for retinal findings . 
 fundoscopy revealed mild disc swelling that could be attributed to the presence of optic disc drusen in both eyes . 
 there was fundoscopic evidence of periphlebitis in the periphery confirmed by fa findings.conclusionsin our case , the unique feature was the presence of optic disc drusen and retinal periphlebitis . 
 the patient 's disc configuration may have contributed to a predisposition for vasculitis in addition to vessel tortuosity .