Relationship between optic disc hemorrhage and localized retinal nerve fiber layer defect in normal-tension glaucoma / 中华眼底病杂志

ABSTRACT

Objective To investigate the relationship between optic d isc hemorrhage and localized retinal never fiber layer defects (RNFLDs) in norma l-tension glaucoma. Methods In 83 patients with normal-tensi on glaucoma, the cumulative frequency and quadrantal distribution of optic disc hemorrhages were retrospectively analyzed. The neighboring relation between opti c disc hemorrhages and RNFLDs in a same quadrant and the changes of correspondin g retinal never fiber layer (RNFL) after the occurrence of optic disc hemorrhage s were observed by tridimensional photochromy of ocular fundus. Results (1) The occurrences and distribution of optic disc hemorrhages 29 of 83(34.94%) patients (33 eyes) had totally 58 occurrences, including 39 in infer iotemporal area, 14 in superiotemporal area, and 5 in other area. (2) The relati onship of neighborhood between optic disc hemorrhages and RNFLDs in the availab le tridimensional photochrome, 23 occurrences in 15 patients (16 eyes) were foun d with cuneiform RNFLDs in the same quadrant, in which 22 was near the border of cuneiform RNFLDs. (3) The changes of corresponding retinal never fiber layer (R NFL) after the occurrence of optic disc hemorrhages the photochromes of 24 occu rrences in 20 patients (21 eyes) were kept well in the initial and the 2-year f ollow-up periods, while the changes of RNFL were found in each region correspon ding to the 19 occurrences (in inferiotemporal or superiotemporal area) in the i nitial photochrome, including 7 cuneiform defects with various sizes, and 12 dev eloped localized RNFLDs next to the initial hemorrhages in the optic disc. No ob vious localized RNFL corresponding to the other 5 occurrences (1 in inferiotempo ral, 1 in superiotemporal, and 3 in other areas) were found in the follow-up pe riod. Conclusion Optic disc hemorrhages in normal-tension gla ucoma occur mostly in inferiotemporal area, and secondly in superiotemporal area of optic disc, and the appearance of optic disc hemorrhages may suggest that th e localized RNFLDs would develop in the associated regions.