Glaucomatous optic disc hemorrhages on confocal scanning laser tomographic images

To evaluate the detectability of glaucomatous optic disc hemorrhages by confocal scanning laser tomography.

The study included 73 eyes of 63 patients, who consecutively showed optic disc hemorrhages on 15 degrees color optic disc photographs taken at baseline or during follow-up examinations and for whom confocal scanning laser tomographic images were additionally available. Of the total number of 92 observed hemorrhages, 51 hemorrhages extended into the parapapillary region and 41 hemorrhages were restricted to the intrapapillary region. The scanning laser tomographic images were searched for the disc hemorrhages already seen on the conventional disc photographs.

Using the reflectivity images, 29 (32%) hemorrhages were detected on the scanning laser tomographs. None of the hemorrhages restricted to the intrapapillary region could be seen on the scanning laser tomographs. By evaluating each of the 32 single images of the scanning laser tomographic image series, 44 (48%) of the hemorrhages were identified on at least one single image. The detectability of disc hemorrhages on the scanning laser tomographs depended significantly on their extension into the parapapillary region or their intrapapillary location. Detectability of disc bleedings was statistically independent of the disc quadrant where the hemorrhage was located, width of the bleeding, size of the optic disc, neuroretinal rim, parapapillary atrophy, and type of glaucoma.

Confocal scanning laser tomography is not very suitable for detection or documentation of optic disc hemorrhages in patients with glaucoma.