Associations between changes in radial peripapillary capillaries and occurrence of disc hemorrhage in normal-tension glaucoma

  • Koji NittaEmail author
  • Kazuhisa Sugiyama
  • Ryotaro Wajima
  • Gaku Tachibana
  • Yutaro Yamada



In order to clarify the association between peripapillary vascular changes and disc hemorrhage (DH) occurrences over time, we analyzed the density of radial peripapillary capillary (RPC) and clinical parameters during follow-up periods in patients with normal-tension glaucoma (NTG).


Seventy-seven eyes of 77 NTG patients were subjected to analysis. We selected patients who had an initial optical coherence tomography angiography (OCTA) scan in 2015 and who had another OCTA scan in 2018 with both OCTA scans showing good-quality images. We investigated the relationships between DH occurrence and each of the following parameters: RPC density, circumpapillary retinal nerve fiber layer (cpRNFL) thickness slope and total deviation (TD) slope.


In the period between the initial and final OCTA, we categorized the patients into 53 sides with DH (DH group) and 101 sides without DH (non-DH group). The ΔRPC density of sides with DH was significantly greater than that of sides without DH (DH, − 4.42 ± 6.43%; without DH, − 2.48 ± 5.29%; p = 0.0469). The cpRNFL thickness slope of sides with DH was significantly faster than that of sides without DH (DH, − 2.85 ± 3.17; without DH, − 0.74 ± 2.46 μm/y; p < 0.0001). The TD slope of sides with DH was significantly faster than that of sides without DH (DH, − 0.50 ± 0.77; without DH, − 0.22 ± 0.53 dB/y; p = 0.0163). As DH occurrence increased, the RPC density significantly decreased (r = −0.255, p = 0.0014). Stepwise multiple regression analysis to identify factors influencing RPC changes showed that frequency of DH (β = − 0.224, p = 0.008) and central corneal thickness (β = − 0.220, p = 0.009) were significantly associated with RPC changes.


DH occurrence may prompt the structural and vascular deterioration of NTG.


OCT angiography Radial peripapillary capillaries Disc hemorrhage Normal-tension glaucoma 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from patients using the “opt-out” prior to the start of this study under approval from the ethics review board.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Fukui-ken Saiseikai HospitalFukuiJapan
  2. 2.Graduate School of Medical ScienceKanazawa UniversityKanazawaJapan

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