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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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Related in: MedlinePlus

A 57-year-old male with normal-tension glaucoma.This patient had recurrent disc hemorrhages (DHs) at different locations of the optic disc in his left eye (A, B, and C, black arrow). DH occurred on the border of a localized retinal nerve fiber layer defect at the inferotemporal location (A’, B’, and C’, white arrow). Fluorescein angiography shows delayed arterial filling (white arrowhead) at the inferotemporal location in the early arteriovenous phase (D and E) and mid-arteriovenous phase (F). Although all the arteries are filled with fluorescein dye at the early arteriovenous phase (D and E), this artery at the inferotemporal location is not filled fully. This artery is kinked at the cup margin proximal to the location of DH.
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pone.0120000.g003: A 57-year-old male with normal-tension glaucoma.This patient had recurrent disc hemorrhages (DHs) at different locations of the optic disc in his left eye (A, B, and C, black arrow). DH occurred on the border of a localized retinal nerve fiber layer defect at the inferotemporal location (A’, B’, and C’, white arrow). Fluorescein angiography shows delayed arterial filling (white arrowhead) at the inferotemporal location in the early arteriovenous phase (D and E) and mid-arteriovenous phase (F). Although all the arteries are filled with fluorescein dye at the early arteriovenous phase (D and E), this artery at the inferotemporal location is not filled fully. This artery is kinked at the cup margin proximal to the location of DH.

Mentions: A 57-year-old male with NTG in his left eye had recurrent DH with an accompanying RNFL defect (Fig 3). The RNFL defect was located at the inferotemporal region at first, and a new RNFL defect appeared in the superotemporal region. Recurrent DHs occurred at the margins of the RNFL defects. Fluorescein angiography showed delayed arterial filling at the 5 o’clock position, where DH was previously present. Fluorescein filling was not present in this artery when venous filling had started at the early arteriovenous phase and also when all the other arteries were filled and the veins were halfway filled at the mid-arteriovenous phase. We could see the kink in the artery at the cup margin where the DH was present.


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

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

A 57-year-old male with normal-tension glaucoma.This patient had recurrent disc hemorrhages (DHs) at different locations of the optic disc in his left eye (A, B, and C, black arrow). DH occurred on the border of a localized retinal nerve fiber layer defect at the inferotemporal location (A’, B’, and C’, white arrow). Fluorescein angiography shows delayed arterial filling (white arrowhead) at the inferotemporal location in the early arteriovenous phase (D and E) and mid-arteriovenous phase (F). Although all the arteries are filled with fluorescein dye at the early arteriovenous phase (D and E), this artery at the inferotemporal location is not filled fully. This artery is kinked at the cup margin proximal to the location of DH.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0120000.g003: A 57-year-old male with normal-tension glaucoma.This patient had recurrent disc hemorrhages (DHs) at different locations of the optic disc in his left eye (A, B, and C, black arrow). DH occurred on the border of a localized retinal nerve fiber layer defect at the inferotemporal location (A’, B’, and C’, white arrow). Fluorescein angiography shows delayed arterial filling (white arrowhead) at the inferotemporal location in the early arteriovenous phase (D and E) and mid-arteriovenous phase (F). Although all the arteries are filled with fluorescein dye at the early arteriovenous phase (D and E), this artery at the inferotemporal location is not filled fully. This artery is kinked at the cup margin proximal to the location of DH.
Mentions: A 57-year-old male with NTG in his left eye had recurrent DH with an accompanying RNFL defect (Fig 3). The RNFL defect was located at the inferotemporal region at first, and a new RNFL defect appeared in the superotemporal region. Recurrent DHs occurred at the margins of the RNFL defects. Fluorescein angiography showed delayed arterial filling at the 5 o’clock position, where DH was previously present. Fluorescein filling was not present in this artery when venous filling had started at the early arteriovenous phase and also when all the other arteries were filled and the veins were halfway filled at the mid-arteriovenous phase. We could see the kink in the artery at the cup margin where the DH was present.

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