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BACKGROUND AND AIM: The aim of this work is to investigate whether optic disc hemorrhages (ODH) lead to significant loss of nerve fibers at the lesion site over time and whether such a loss is reflected by visual field defects corresponding to the affected nerve fiber bundle. METHODS: In this retrospective study of ten sequential glaucoma patients (ten eyes) with ODH, we used high-resolution OCT circular scans (Spectralis HRA + OCT, Heidelberg Engineering, Heidelberg, Germany) to determine peripapillary retinal nerve fiber layer (RNFL) thickness at the time of ODH presentation and at follow-up visit between 3 and 6 months. Corresponding perimetric data were analyzed for global (mean defect, MD) and localized progression of visual field defects. RESULTS: ODH were mostly located in the inferior quadrant as determined clinically and from fundus photographs. Iterative OCT imaging revealed a significant RNFL reduction in the affected quadrant relative to the respective quadrant in the fellow eye (RNFL change = -2.25 ± 2.69 μm vs. 0.75 ± 2.78 μm, p = 0.01) within 120 ± 43 days. However, only three cases presented with new/progressive nerve fiber bundle defects corresponding to the lesion site within the given follow-up period. CONCLUSIONS: ODH lead to a significantly higher RNFL loss at the lesion site relative to the overall structural progression in glaucoma patients. However, this focal change is not generally reflected by respective nerve fiber bundle defects in the time frame investigated.

Original publication

DOI

10.1007/s00417-011-1825-3

Type

Journal article

Journal

Graefes Arch Clin Exp Ophthalmol

Publication Date

04/2012

Volume

250

Pages

583 - 587

Keywords

Aged, Cross-Sectional Studies, Disease Progression, Female, Glaucoma, Open-Angle, Humans, Intraocular Pressure, Male, Nerve Fibers, Optic Disk, Retinal Ganglion Cells, Retinal Hemorrhage, Retrospective Studies, Tomography, Optical Coherence, Vision Disorders, Visual Acuity, Visual Field Tests, Visual Fields