Yoon Jooyoung, Sung Kyung Rim, Kim Ko Eun, Han Hyo Ji, Kim Joon Mo
Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea.
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Sci Rep. 2025 Feb 1;15(1):3969. doi: 10.1038/s41598-025-86460-7.
This study investigated the changes in optic nerve head (ONH) microvasculature, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and visual field (VF) sensitivity following the absorption of optic disc hemorrhage (DH). Intradisc vessel density (dVD) was calculated using a 3 × 3 mm optic disc scan in 60 eyes of 60 patients with primary open angle glaucoma and DH who had undergone two or more swept-source optical coherence tomography angiography exams. Clinical parameters at the time of DH occurrence and after absorption, as well as those between the subgroups based on DH recurrence and location, were compared. Linear regression analysis was performed to identify factors associated with changes in cpRNFL thickness in the DH-affected quadrant. Mean dVD, cpRNFL thickness, and VF sensitivity significantly decreased after DH absorption (all P < 0.05). The reduction in dVD was more pronounced in eyes with recurrent DH compared to those with a single episode (P = 0.032). Eyes with DH occurring within or at the margin of the disc cup showed a greater dVD reduction than those with DH occurring outside the disc cup (P = 0.049). The reduction in cpRNFL thickness in the DH-affected quadrant correlated with dVD reduction in the same quadrant (β = 0.370, P = 0.013) and DH recurrence (β = -2.617, P = 0.033). This finding suggests that DH pathogenesis may be associated with changes in optic disc vasculature, contributing to glaucomatous progression.
本研究调查了视盘出血（DH）吸收后视神经乳头（ONH）微血管系统、视盘周围视网膜神经纤维层（cpRNFL）厚度和视野（VF）敏感度的变化。使用3×3毫米视盘扫描计算了60例患有原发性开角型青光眼和DH且接受过两次或更多次扫频源光学相干断层扫描血管造影检查的患者60只眼中的视盘内血管密度（dVD）。比较了DH发生时和吸收后的临床参数，以及基于DH复发和位置的亚组之间的参数。进行线性回归分析以确定与DH受累象限中cpRNFL厚度变化相关的因素。DH吸收后，平均dVD、cpRNFL厚度和VF敏感度均显著降低（均P<0.05）。与单次发作的眼睛相比，复发性DH的眼睛dVD降低更明显（P = 0.032）。视盘杯内或边缘发生DH的眼睛比视盘杯外发生DH的眼睛dVD降低更大（P = 0.049）。DH受累象限中cpRNFL厚度的降低与同一象限中dVD的降低（β = 0.370，P = 0.013）和DH复发（β = -2.617，P = 0.033）相关。这一发现表明，DH的发病机制可能与视盘血管系统的变化有关，促进青光眼的进展。
