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Optic disc hemorrhages in glaucoma and common clinical features
Zeynep Kayaarasi Ozturker1, Kristen Munro2, Neeru Gupta3
1Glaucoma Unit, University of Toronto, Toronto, Ont.; Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ont.
Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|December 9, 2017
Summary
Optic disc hemorrhages, often seen in glaucoma patients, typically appear inferiorly and are linked to notches. These hemorrhages can indicate glaucoma damage even with normal intraocular pressure and early visual field loss.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Optic Nerve Head Imaging
Background:
- Optic disc hemorrhages are potential indicators of glaucomatous damage.
- Understanding their characteristics is crucial for glaucoma management.
Purpose of the Study:
- To analyze optic nerve head stereophotographs for optic disc hemorrhages.
- To describe bleeding patterns and patient characteristics associated with these hemorrhages.
Main Methods:
- Retrospective, cross-sectional study of 1113 optic nerve stereophotograph pairs from 562 patients.
- Systematic review of stereophotographs for disc hemorrhages and optic nerve head features.
- Analysis of demographic and clinical data from patient charts.
Main Results:
- Disc hemorrhages were observed in 7.1% of patients, predominantly in those with open-angle glaucoma (57.5%).
- Hemorrhages were most common in the inferotemporal region (60.8%), often flame/splinter-shaped (70.6%) and associated with a notch (64.4%).
- Most hemorrhages occurred with intraocular pressure within the normal range and were linked to early visual field defects (42.5%).
Conclusions:
- Optic disc hemorrhages in glaucoma are frequently inferior, associated with notches, and can occur with normal intraocular pressure and minimal visual field loss.
- These findings underscore the significance of optic nerve head examination for detecting disc hemorrhages as a biomarker of glaucoma progression.
- Careful stereophotograph analysis is vital for identifying these subtle signs of optic nerve damage.
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