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E. T. Vesti, M. Harju; Spatial Relationship Between Optic Disc Hemorrhages and Nerve Fiber Layer Defects. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4618.
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© ARVO (1962-2015); The Authors (2016-present)
To study relationship between the location of the optic disc hemorrhages and retinal nerve fiber layer defects.
20 eyes of 20 patients (1 male, 19 females) with one or two optic disc hemorrhages were followed for 6 months. The median age was 65 years (range 50 - 81 years). 12 did not use any systemic medication. Of the 8 patients, 7 had high systemic blood pressure, 3 had asthma, and 3 had ischemic heart disease. A clinical ophthalmological examination (visual acuity, refraction, applanation tonometry, funduscopy after pupillary dilatation) and photography of the optic nerve head and retinal nerve fiber layer (RNFL) with a digital fundus camera were performed at the time of detection of the hemorrhage and 6 months thereafter. The location of the hemorrhages and RNFL defects were recorded as well as possible enlargement of the RNFL defects at 6 months.
Of the 20 eyes, 14 had glaucoma (4 primary open-angle glaucoma, 6 normal tension glaucoma, 3 pseudoexfoliative glaucoma, 1 pigmentary glaucoma) and 6 were healthy. 18 eyes had one hemorrhage and 2 eyes had two hemorrhages. Of the 22 hemorrhages, 13 were located inferiorly or infero-temporally, and 6 superiorly or supero-temporally. Two hemorrhages were located infero-nasally and one nasally. 12 of the 22 hemorrhages were located on the edge of a wedge-shaped RNFL defect, 6 in the area of a diffuse RNFL thinning, and in 4 eyes no RNFL loss was detected. In 9 eyes, also other RNFL defects than those in the proximity of the hemorrhage were detected. At the 6 month follow-up visit, 17 of the 22 hemorrhages had disappeared and no new hemorrhages had appeared. The size of the RNFL defects had remained stable.
The optic disc hemorrhages seem to appear at the border of an existing RNFL defect or in the area of an existing diffuse RNFL loss. The extent of the RNFL loss doesn’t seem to change during 6 months follow-up.
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