To analyze the features of optic nerve head drusen (ONHD) observed on the optical coherence tomography (OCT) of pediatric and adolescent patients and to compare the characteristics of diagnosed ONHD pediatric and adolescent patients with the control group.

We performed a retrospective chart review of pediatric and adolescent patients with nasal elevation or marginal blurring of the optic nerve head on either direct ophthalmoscopic examination or fundus photography. Patients were compared with a control group of the same age who had normal optic nerve heads and no abnormal findings except refractive errors under ophthalmic examination including OCT.

There were 29 eyes (n = 16) with ONHD as a subretinal mass-like lesion on OCT among 84 eyes with nasal elevation or marginal blurring of the optic nerve head on OCT. Thirteen patients (18.8%) were diagnosed with ONHD in both eyes. The following 3 groups were compared: group 1, showing nasal elevation or marginal blurring of the optic nerve head on OCT and diagnosed with ONHD; group 2, without ONHD; group 3, normal controls. The spherical equivalent was significantly different among the groups ( p < 0.001). Compared with group 3, group 1 showed peripapillary retinal nerve fiber layer thickening of the temporal area; however, there was no difference between groups 1 and 2.

Buried ONHD in children and adolescents may be asymptomatic and the diagnosis can be made when a subretinal mass-like lesion is detected on OCT.