Changes in retinal nerve fiber layer thickness after optic disc hemorrhage in glaucomatous eyes

The aim of this study was to investigate the changes in longitudinal retinal nerve fiber layer thickness (RNFLT) as determined by spectral-domain optical coherence tomography (OCT) after optic disc hemorrhage (DH) in glaucomatous eyes.

A total of 65 eyes with unilateral DH and 65 contralateral eyes without DH were subjected to RNFLT measurements by using OCT at the time of DH detection and at 1 year (12±2 mo) and 2 years (24±2 mo) later. For the definition of event-based significant RNFLT changes (a change beyond the upper limit of the 95% confidence interval of test-retest variability), 50 eyes with stable glaucoma without DH that had undergone OCT examinations 3 times with a 1-year interval were also enrolled. Clock-hour sector RNFLT in the eyes with DH and clock-hour sector RNFLT at equivalent locations in the contralateral eyes without DH were analyzed to assess localized and spatially compatible RNFLT changes associated with DH.

Of the eyes with DH, 38.5% showed decrease in RNFLT and 6.2% showed increase in RNFLT 1 year after DH detection, whereas 58.5% showed decrease in RNFLT and no eye showed increase in RNFLT 2 years after DH detection. Significant decreases in RNFLT in the eyes with DH were associated with the presence of recurrent DH and greater baseline RNFLT (P<0.05). Of the contralateral eyes without DH, 4.6% and 15.4% showed decrease in RNFLT 1 and 2 years after DH detection, respectively.

In the glaucomatous eyes, DH was associated with progressive decrease in RNFLT as determined by OCT, especially in the eyes with recurrent DH and greater baseline RNFLT.