Tachibana Gaku, Higashide Tomomi, Nitta Koji, Sugiyama Kazuhisa
Department of Ophthalmology, Fukui-Ken Saiseikai Hospital, Fukui 918-8503, Japan.
Department of Ophthalmology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
J Clin Med. 2023 Jun 12;12(12):3996. doi: 10.3390/jcm12123996.
Disc hemorrhage (DH) is often associated with glaucoma progression. A vertically asymmetrical pattern is typical of glaucoma progression, but it remains unclear whether the association between DH and glaucoma progression differs between the superior and inferior hemiretinas. We compared the thickness changes of the macular ganglion cell complex (GCC) in the hemiretinas of normal-tension glaucoma patients with or without DH, as well as between hemiretinas positive and negative for DH, during five years. Both the superior and inferior hemiretinas in the DH-positive group had a more negative GCC thickness slope in association with more DH counts compared to those in the DH-negative group. Conversely, only the inferior hemiretina exhibited a significant relationship between GCC thickness slope and DH counts when hemiretinas positive and negative for DH in the DH-positive group were compared. In the superior hemifield, the slope of the total deviation changes in the DH-positive hemifield of the DH-positive group was more negative compared to that of the DH-negative group. The association between DH and glaucoma progression in the macular GCC may be stronger in the inferior hemiretina, suggesting that more attention should be paid to DH in the inferior disc area as a sign of glaucoma progression.
视盘出血（DH）常与青光眼进展相关。垂直不对称模式是青光眼进展的典型表现，但DH与青光眼进展之间的关联在视网膜上半区和下半区是否存在差异仍不清楚。我们比较了正常眼压性青光眼患者在5年期间，有或无DH的半视网膜以及DH阳性和阴性半视网膜之间黄斑神经节细胞复合体（GCC）的厚度变化。与DH阴性组相比，DH阳性组的上半视网膜和下半视网膜GCC厚度斜率更负，且DH计数更多。相反，当比较DH阳性组中DH阳性和阴性的半视网膜时，只有下半视网膜的GCC厚度斜率与DH计数之间存在显著关系。在上半视野中，DH阳性组的DH阳性半视野总偏差变化斜率比DH阴性组更负。黄斑GCC中DH与青光眼进展之间的关联在下半视网膜可能更强，这表明应更多关注视盘下半区的DH，将其作为青光眼进展的一个迹象。
