Optic disc hemorrhage in nonglaucomatous eyes: A cross-sectional study with average 8-year follow-up

PLoS One. 2020 Aug 17;15(8):e0237796. doi: 10.1371/journal.pone.0237796. eCollection 2020.

Abstract

Purpose: To characterize changes in the retinal nerve fiber layer (RNFL) and peripapillary vessel density (VD) at the site of disc hemorrhage (DH) in nonglaucomatous eyes.

Materials and methods: This retrospective cross-sectional study included nonglaucomatous eyes diagnosed with unilateral DH. The change of DH was recorded using disc photography. Both anatomical data and functional visual field (VF) data were collected using optical coherence tomography angiography and Humphrey VF examination.

Results: Sixteen patients were included with average follow-up duration of 95 months. Almost half of DH episodes was initially presented at the inferotemporal area of the optic disc. Pigment formation at the previous DH site after resolution was noted in 12.5% of eyes. Sectoral radial peripapillary VD at the DH site was significantly lower in DH eyes than in the control group; however, the sectoral RNFL thickness at the DH site was not significantly decreased. Progression of the VF defect corresponding to the DH site was found in 81.3% of eyes despite regular use of antiglaucoma agents. The mean change in the VF mean deviation was -0.64 dB/year in DH eyes.

Conclusion: During long follow-up periods, decreased peripapillary VD at the DH site and progression of the VF defect corresponding to the DH site were detected in nonglaucomatous eyes. Retinal pigmentation with an RNFL defect is a clue for DH, although RNFL showed no significant change. Antiglaucoma treatment may not prevent the deterioration of visual function.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Optic Disk / diagnostic imaging
  • Optic Disk / physiopathology
  • Optic Nerve Diseases / complications*
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / physiopathology
  • Retina / diagnostic imaging
  • Retina / pathology
  • Retinal Hemorrhage / complications*
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / physiopathology
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vision Disorders / diagnosis
  • Vision Disorders / etiology*
  • Vision Disorders / physiopathology
  • Visual Field Tests / statistics & numerical data
  • Visual Fields / physiology

Grants and funding

The author(s) received no specific funding for this work.