Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan.
PLoS One. 2020 Aug 17;15(8):e0237796. doi: 10.1371/journal.pone.0237796. eCollection 2020.
To characterize changes in the retinal nerve fiber layer (RNFL) and peripapillary vessel density (VD) at the site of disc hemorrhage (DH) in nonglaucomatous eyes.
This retrospective cross-sectional study included nonglaucomatous eyes diagnosed with unilateral DH. The change of DH was recorded using disc photography. Both anatomical data and functional visual field (VF) data were collected using optical coherence tomography angiography and Humphrey VF examination.
Sixteen patients were included with average follow-up duration of 95 months. Almost half of DH episodes was initially presented at the inferotemporal area of the optic disc. Pigment formation at the previous DH site after resolution was noted in 12.5% of eyes. Sectoral radial peripapillary VD at the DH site was significantly lower in DH eyes than in the control group; however, the sectoral RNFL thickness at the DH site was not significantly decreased. Progression of the VF defect corresponding to the DH site was found in 81.3% of eyes despite regular use of antiglaucoma agents. The mean change in the VF mean deviation was -0.64 dB/year in DH eyes.
During long follow-up periods, decreased peripapillary VD at the DH site and progression of the VF defect corresponding to the DH site were detected in nonglaucomatous eyes. Retinal pigmentation with an RNFL defect is a clue for DH, although RNFL showed no significant change. Antiglaucoma treatment may not prevent the deterioration of visual function.
描述非青光眼眼中盘沿出血（DH）部位视网膜神经纤维层（RNFL）和视盘周围血管密度（VD）的变化。
本回顾性横断面研究纳入了单侧 DH 诊断的非青光眼眼。DH 的变化通过盘片照相记录。使用光相干断层扫描血管造影和 Humphrey VF 检查同时收集解剖学数据和功能视野（VF）数据。
纳入 16 例患者，平均随访时间为 95 个月。几乎一半的 DH 发作最初出现在视盘的下颞区。12.5%的眼在 DH 消退后可见先前 DH 部位的色素形成。DH 眼的 DH 部位扇形径向视盘周围 VD 明显低于对照组；然而，DH 部位的扇形 RNFL 厚度无明显减少。尽管定期使用抗青光眼药物，但仍有 81.3%的眼发现与 DH 部位相对应的 VF 缺损进展。DH 眼的 VF 平均偏差平均变化为 -0.64 dB/年。
在长期随访期间，非青光眼眼中 DH 部位的视盘周围 VD 减少和与 DH 部位相对应的 VF 缺损进展被检测到。虽然 RNFL 无明显变化，但存在视网膜色素沉着和 RNFL 缺损是 DH 的线索。抗青光眼治疗可能无法阻止视功能恶化。
