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C. Y. Mardin, T. Nguyen, A. G. M. Juenemann, R. Laemmer; Neuroretinal Rim and Retinal Nerve Fibre Layer in Glaucoma Eyes With Single and Recurrent Optic Disc Haemorrhages. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1972.
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© ARVO (1962-2015); The Authors (2016-present)
Optic disc haemorrhages (ODH) are a significant risk factor at the optic disc for progression of the disease. The purpose of the study was to identify morphological, prognostic factors for singular and recurrent ODH and to investigate the course of morphological changes in a long-term follow-up.
In the ongoing study of the Erlangen Glaucoma Registry 8/8 with singular and 9/7 eyes/patients with recurrent ODH were identified. Neuroretinal rim area (NRR) with optic disc planimetry of disc stereographs and retinal nerve fibre (RNF) thickness measurements with nerve fibre polarimetry were performed annually besides standard clinical examination for glaucoma. ODH were assessed on optic disc stereographs by two independent and experienced examiners (CYM, RL) masked for the sequence of the pictures and morphometric data. Baseline was defined as the examination before occurrence of the first ODH.
Patients with singular ODH were significantly younger (54.2 ± 9.1a), than those with recurrent ODH (65.0 ± 4.3a; p= 0.01). Mean follow-up was 4.5 ± 1.6a and 5.4 ± 1.2a respectively. In both groups the most common site of ODH was the temporal superior sector, followed by the temporal inferior. Recurrent ODH were most often found in low-tension glaucomas (67%), whereas in single ODH eyes high-tension glaucoma was prevalent (64%). Recurrent ODH showed a significant loss of NRR (0.054 ± 0.04mm² vs 0.015 ± 0.01mm² ) globally and in the sector of ODH (0.033 ± 0.02mm² vs 0.002 ± 0.03mm²) whereas singular ODH discs not. Enlargement of zone beta was significant in both groups (0.164 ± 0.15mm² vs 0.222 ± 0.16mm²; p<0.05). At the first visit NRR area and RNF thickness in eyes with recurrent ODH already showed lower values than in those with singular ODH. Neuronal network’s the number of nerve fibre polarimetry was significantly lower in the singular ODH group (p<0.05).
Eyes with recurrent ODH have a tendency to loose more NRR and RNF than eyes with singular ODH in a mean follow-up of five years. Low values for NRR area and RNF thickness seem to be a prognostic negative factor for recurrent ODH.
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