The role of optical coherence tomography raster imaging as a valuable diagnostic tool in the differential between optic disc hemorrhage and vitreopapillary traction.

An acute presentation of an optic disc hemorrhage can indicate true optic nerve head damage or can be a result of tractional forces on the vitreopapillary interface. An isolated optic disc hemorrhage secondary to vitreopapillary traction (VPT) can mimic the clinical presentation of a glaucomatous process or that of an underlying ocular or systemic condition. This article highlights the use of spectral domain optical coherence tomography (SD-OCT) 5 line raster (5LR) in differentiating true optic disc hemorrhages from those as a result of tractional forces. Two examples are given of patients presenting to our clinic with unilateral optic disc hemorrhages and various underlying disease processes as risk factors. With the use of SD-OCT 5LR imaging, VPT was implicated as the cause of the disc hemorrhages in both patients. Although this imaging tool alone is not enough to rule out a disease process such as glaucoma or prevent the need for additional diagnostic testing, SD-OCT 5LR is a noninvasive and valuable clinical tool in distinguishing VPT from other etiologies of an optic nerve hemorrhage.