Abstract
Purpose: :
To evaluate glaucoma progression after an initial disc hemorrhage (DH) by optical coherence tomography (StratusOCT: Carl Zeiss Meditec, Inc., Dublin, CA).
Methods: :
Forty four eyes with a unilateral DH were allocated to the DH group and the 44 contralateral eyes to the non-DH group. Thinning of the retinal nerve fiber layer (RNFL) by OCT was defined as a decrease beyond the upper 95 % limit of test-retest variability defined at the 95 % confidence level of 44 control subjects. The DH and non-DH group were compared in terms of OCT-derived glaucoma progressions after initial DH. In addition, clock hour locations of OCT-derived progression were compared with those of DHs.
Results: :
After a median 38.8 months of follow-up, 72.7 % (32/44) of eyes in the DH group showed OCT-determined clock hour thickness progression, as compared with 27.3 % (12/44) in the non-DH group (P < 0.0001, Fisher’s exact test). The DH-group showed more rapid and greater falls in clock hour thickness progression than the non-DH group (P < 0.0001, log rank test). Twenty nine eyes (90.6 %) showed progression within 1 clock hour of the location of DH. However, no significant inter-group differences were observed in terms of quadrant or average RNFL thicknesses (P > 0.05, respectively, Fisher’s exact test).
Conclusions: :
Rapid, spatially-compatible, localized thinning of the RNFL after initial DH was detected by StratusOCT. This finding suggests DH is not a simple epiphenomenon of structural damage, but that it may also lead to subsequent RNFL thinning.