The Relationship between Retinal Nerve Fiber Layer Thickness and Optic Disc Hemorrhage

Abstract

Purpose: : To investigate the relationship between retinal nerve fiber layer (RNFL) thickness and optic disc hemorrhage (ODH) in patients with glaucoma.

Methods: : The sample comprised 110 participants (mean age 63±9yrs; 59 female) from outpatient Glaucoma Clinics at the Toronto Western Hospital. All participants had digital fundus photographs (Canon CR-DGi) and quantification of RNFL thickness using circular peripapillary SD-OCT scans (Spectralis, Heidelberg Engineering). A minimum of 3 sets of images were acquired and the best quality image set was chosen for analysis. From this sample, 10 patients (mean age 65±9yrs; 7 females) were found to have newly-diagnosed ODH as confirmed by digital photographs. Average RNFL thickness profiles and volumetric neuroretinal rim (NRR) values were determined for each clock hour, quadrant and pre-determined sector provided by the SD-OCT program. RNFL thickness was analysed in the corresponding area of ODH.

Results: : Compared to normative database values, glaucoma patients with recent ODH had significant peripapillary RNFL thinning at the site of the hemorrhage (p<0.001). Furthermore, when compared to the mirror image sector of the same eye there was evidence of focal RNFL and volumetric NRR loss (p=0.008 and p=0.002, respectively). The clock hour and quarter in which the ODH was evident also showed evidence of RNFL thinning when compared to all other areas (p<0.001)

Conclusions: : RNFL thinning is associated with concurrent optic disc hemorrhage.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • nerve fiber layer