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Optic disc hemorrhage is related to various hemodynamic findings by disc angiography.

Park HY, Jeong HJ, Kim YH, Park CK - PLoS ONE (2015)

Bottom Line: Prevalence of DH and location of the proximal border were recorded from disc photographs.Arm-retina time, arteriovenous transit time, disc filling time, choroidal filling time, and venous filling time were measured as retinal circulation parameters.These findings suggest that vascular and hemodynamic changes due to glaucomatous structural changes cause DH in relation to localized RNFL defects.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background: To investigate the hemodynamic characteristics of glaucoma eyes with disc hemorrhage (DH) by disc fluorescein angiography, and its relationship with glaucomatous changes of the optic disc and surrounding retinal nerve fiber layer (RNFL).

Methods: This study included 35 glaucoma eyes with DH who were followed up at least 5 years and had DH at presentation. Eyes were classified as eyes with DH at the border of localized RNFL defects and eyes with DH not related to localized RNFL defects. Prevalence of DH and location of the proximal border were recorded from disc photographs. Fluorescein angiography was performed 3 months after detecting the DH. Arm-retina time, arteriovenous transit time, disc filling time, choroidal filling time, and venous filling time were measured as retinal circulation parameters. The presence of disc filling defects and disc leaks were evaluated.

Results: There were 19 (54.3%) eyes with DH accompanying localized RNFL defects. The arm-retina time was prolonged in eyes with DH not related to RNFL defects (P = 0.044) and the arteriovenous transit time was prolonged in eyes with DH accompanying RNFL defects (P = 0.029). Among eyes with DH accompanying RNFL defects, 11 (57.9%) had vessel filling defects or delayed filling indicating blood flow stasis at the cup margin proximal to where DH occurred. Eyes with DH not related to RNFL defects did not show vessel filling defects or delayed filling.

Conclusions and relevance: Eyes with DH related to RNFL defects showed prolonged arteriovenous transit time and had frequent vessel filling defects or delayed filling indicating blood flow stasis and thrombus formation at the site DH occurred. These findings suggest that vascular and hemodynamic changes due to glaucomatous structural changes cause DH in relation to localized RNFL defects.

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A 47-year-old female with normal-tension glaucoma.Disc hemorrhage (DH, black arrow) was present at the border of a localized retinal nerve fiber layer defect in her right eye (A). Fluorescein angiography was performed 3 months after the disappearance of the DH in the disc photograph (B). A vessel filling defect (white arrow) was found at the mid-arteriovenous phase (C), early late phase (D), and late phase of fluorescein angiography (E). The vessel filling defect was proximal to the location of the DH. This vein is reflected at the cup margin, and the proximal location of DH is at the cup margin.
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pone.0120000.g002: A 47-year-old female with normal-tension glaucoma.Disc hemorrhage (DH, black arrow) was present at the border of a localized retinal nerve fiber layer defect in her right eye (A). Fluorescein angiography was performed 3 months after the disappearance of the DH in the disc photograph (B). A vessel filling defect (white arrow) was found at the mid-arteriovenous phase (C), early late phase (D), and late phase of fluorescein angiography (E). The vessel filling defect was proximal to the location of the DH. This vein is reflected at the cup margin, and the proximal location of DH is at the cup margin.

Mentions: Among the 19 eyes with DH accompanying a RNFL defect, 11 (57.9%) had vessel filling defect or delayed filling, indicating blood flow stasis in these eyes. The location of vessel filling defects or delayed filling was the cup margin proximal to where the DH occurred. Any eyes with DH not related to a RNFL defect showed neither vessel filling defects nor delayed filling. One of the eyes with DH not related to a RNFL defect had a thrombus in the vessel at the location where the DH occurred. Representative cases are shown in Figs 2–5. Fig 2 shows the case of a 47-year-old female with NTG in her right eye. She had a localized RNFL defect in the inferotemporal region, and the VF showed superior nasal step defects at the corresponding region. DH occurred once during follow-up at the proximal border of the RNFL defect. Delay in venous filling proximal to the previous location of DH was observed from the mid-arteriovenous phase through the early late phase. At the late phase, all other veins around the ONH were filled with fluorescein dye except the vein proximal to the DH. This vein was kinked at the cup margin, and venous flow stasis was proximal to the cup margin where the DH occurred.


Optic disc hemorrhage is related to various hemodynamic findings by disc angiography.

Park HY, Jeong HJ, Kim YH, Park CK - PLoS ONE (2015)

A 47-year-old female with normal-tension glaucoma.Disc hemorrhage (DH, black arrow) was present at the border of a localized retinal nerve fiber layer defect in her right eye (A). Fluorescein angiography was performed 3 months after the disappearance of the DH in the disc photograph (B). A vessel filling defect (white arrow) was found at the mid-arteriovenous phase (C), early late phase (D), and late phase of fluorescein angiography (E). The vessel filling defect was proximal to the location of the DH. This vein is reflected at the cup margin, and the proximal location of DH is at the cup margin.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400035&req=5

pone.0120000.g002: A 47-year-old female with normal-tension glaucoma.Disc hemorrhage (DH, black arrow) was present at the border of a localized retinal nerve fiber layer defect in her right eye (A). Fluorescein angiography was performed 3 months after the disappearance of the DH in the disc photograph (B). A vessel filling defect (white arrow) was found at the mid-arteriovenous phase (C), early late phase (D), and late phase of fluorescein angiography (E). The vessel filling defect was proximal to the location of the DH. This vein is reflected at the cup margin, and the proximal location of DH is at the cup margin.
Mentions: Among the 19 eyes with DH accompanying a RNFL defect, 11 (57.9%) had vessel filling defect or delayed filling, indicating blood flow stasis in these eyes. The location of vessel filling defects or delayed filling was the cup margin proximal to where the DH occurred. Any eyes with DH not related to a RNFL defect showed neither vessel filling defects nor delayed filling. One of the eyes with DH not related to a RNFL defect had a thrombus in the vessel at the location where the DH occurred. Representative cases are shown in Figs 2–5. Fig 2 shows the case of a 47-year-old female with NTG in her right eye. She had a localized RNFL defect in the inferotemporal region, and the VF showed superior nasal step defects at the corresponding region. DH occurred once during follow-up at the proximal border of the RNFL defect. Delay in venous filling proximal to the previous location of DH was observed from the mid-arteriovenous phase through the early late phase. At the late phase, all other veins around the ONH were filled with fluorescein dye except the vein proximal to the DH. This vein was kinked at the cup margin, and venous flow stasis was proximal to the cup margin where the DH occurred.

Bottom Line: Prevalence of DH and location of the proximal border were recorded from disc photographs.Arm-retina time, arteriovenous transit time, disc filling time, choroidal filling time, and venous filling time were measured as retinal circulation parameters.These findings suggest that vascular and hemodynamic changes due to glaucomatous structural changes cause DH in relation to localized RNFL defects.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT

Background: To investigate the hemodynamic characteristics of glaucoma eyes with disc hemorrhage (DH) by disc fluorescein angiography, and its relationship with glaucomatous changes of the optic disc and surrounding retinal nerve fiber layer (RNFL).

Methods: This study included 35 glaucoma eyes with DH who were followed up at least 5 years and had DH at presentation. Eyes were classified as eyes with DH at the border of localized RNFL defects and eyes with DH not related to localized RNFL defects. Prevalence of DH and location of the proximal border were recorded from disc photographs. Fluorescein angiography was performed 3 months after detecting the DH. Arm-retina time, arteriovenous transit time, disc filling time, choroidal filling time, and venous filling time were measured as retinal circulation parameters. The presence of disc filling defects and disc leaks were evaluated.

Results: There were 19 (54.3%) eyes with DH accompanying localized RNFL defects. The arm-retina time was prolonged in eyes with DH not related to RNFL defects (P = 0.044) and the arteriovenous transit time was prolonged in eyes with DH accompanying RNFL defects (P = 0.029). Among eyes with DH accompanying RNFL defects, 11 (57.9%) had vessel filling defects or delayed filling indicating blood flow stasis at the cup margin proximal to where DH occurred. Eyes with DH not related to RNFL defects did not show vessel filling defects or delayed filling.

Conclusions and relevance: Eyes with DH related to RNFL defects showed prolonged arteriovenous transit time and had frequent vessel filling defects or delayed filling indicating blood flow stasis and thrombus formation at the site DH occurred. These findings suggest that vascular and hemodynamic changes due to glaucomatous structural changes cause DH in relation to localized RNFL defects.

Show MeSH
Related in: MedlinePlus