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Optical coherence tomography shows progressive local nerve fiber loss after disc hemorrhages in glaucoma patients

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background and aim

The aim of this work is to investigate whether optic disc hemorrhages (ODH) lead to significant loss of nerve fibers at the lesion site over time and whether such a loss is reflected by visual field defects corresponding to the affected nerve fiber bundle.

Methods

In this retrospective study of ten sequential glaucoma patients (ten eyes) with ODH, we used high-resolution OCT circular scans (Spectralis HRA + OCT, Heidelberg Engineering, Heidelberg, Germany) to determine peripapillary retinal nerve fiber layer (RNFL) thickness at the time of ODH presentation and at follow-up visit between 3 and 6 months. Corresponding perimetric data were analyzed for global (mean defect, MD) and localized progression of visual field defects.

Results

ODH were mostly located in the inferior quadrant as determined clinically and from fundus photographs. Iterative OCT imaging revealed a significant RNFL reduction in the affected quadrant relative to the respective quadrant in the fellow eye (RNFL change = −2.25 ± 2.69 μm vs. 0.75 ± 2.78 μm, p = 0.01) within 120 ± 43 days. However, only three cases presented with new/progressive nerve fiber bundle defects corresponding to the lesion site within the given follow-up period.

Conclusions

ODH lead to a significantly higher RNFL loss at the lesion site relative to the overall structural progression in glaucoma patients. However, this focal change is not generally reflected by respective nerve fiber bundle defects in the time frame investigated.

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References

  1. Wang Y, Xu L, Hu L, Wang Y, Yang H, Jonas JB (2006) Frequency of optic disk hemorrhages in adult Chinese in rural and urban china: the Beijing eye study. Am J Ophthalmol 142:241–246

    Article  PubMed  Google Scholar 

  2. Healey PR, Mitchell P, Smith W, Wang JJ (1998) Optic disc hemorrhages in a population with and without signs of glaucoma. Ophthalmology 105:216–223

    Article  PubMed  CAS  Google Scholar 

  3. Drance SM, Fairclough M, Butler DM, Kottler MS (1977) The importance of disc hemorrhage in the prognosis of chronic open angle glaucoma. Arch Ophthalmol 95:226–228

    Article  PubMed  CAS  Google Scholar 

  4. Demirel S, De Morares G, Gardiner S, Liebmann J, Cioffi G, Ritch R, Gordon M, Kass M (2011) Rates of visual field change in eyes with optic disc hemorrhage in the ocular hypertension treatment study. Invest Ophth Vis Sci: ARVO E-Abstract 2119

  5. Drexler W, Fujimoto JG (2008) State-of-the-art retinal optical coherence tomography. Prog Retin Eye Res 27:45–88

    Article  PubMed  Google Scholar 

  6. Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA (1991) Optical coherence tomography. Science 254:1178–1181

    Article  PubMed  CAS  Google Scholar 

  7. Wolf-Schnurrbusch UEK, Ceklic L, Brinkmann CK, Iliev ME, Frey M, Rothenbuehler SP, Enzmann V, Wolf S (2009) Macular thickness measurements in healthy eyes using six different optical coherence tomography instruments. Invest Ophth Vis Sci 50:3432–3437

    Article  Google Scholar 

  8. Fischer MD, Synofzik M, Heidlauf R, Schicks J, Srulijes K, Kernstock C, Berg D, Schöls L, Schiefer U (2011) Retinal nerve fiber layer loss in multiple system atrophy. Mov Disord 26:914–916

    Article  PubMed  Google Scholar 

  9. Bendschneider D, Tornow RP, Horn FK, Laemmer R, Roessler CW, Juenemann AG, Kruse FE, Mardin CY (2010) Retinal nerve fiber layer thickness in normals measured by spectral domain OCT. J Glaucoma 19:475–482

    Article  PubMed  Google Scholar 

  10. Wollstein G, Kagemann L, Bilonick RA, Ishikawa H, Folio LS, Gabriele ML, Ungar AK, Duker JS, Fujimoto JG, Schuman JS (2011) Retinal nerve fibre layer and visual function loss in glaucoma: the tipping point. Brit J Ophthalmol. doi:10.1136/bjo.2010.196907

  11. Horn FK, Mardin CY, Laemmer R, Baleanu D, Juenemann AM, Kruse FE, Tornow RP (2009) Correlation between local glaucomatous visual field defects and loss of nerve fiber layer thickness measured with polarimetry and spectral domain OCT. Invest Ophthalmol Vis Sci 50:1971–1977

    Article  PubMed  Google Scholar 

  12. Sugiyama K, Uchida H, Tomita G, Sato Y, Iwase A, Kitazawa Y (1999) Localized wedge-shaped defects of retinal nerve fiber layer and disc hemorrhage in glaucoma. Ophthalmology 106:1762–1767

    Article  PubMed  CAS  Google Scholar 

  13. Airaksinen PJ, Mustonen E, Alanko HI (1981) Optic disc haemorrhages precede retinal nerve fibre layer defects in ocular hypertension. Acta Ophthalmol 59:627–641

    CAS  Google Scholar 

  14. Choi F, Park KH, Kim DM, Kim TW (2007) Retinal nerve fiber layer thickness evaluation using optical coherence tomography in eyes with optic disc hemorrhage. Ophthal Surg Las Im 38:118–125

    Google Scholar 

  15. Jeoung JW, Park KH, Kim JM, Kang SH, Kang JH, Kim T-W, Kim DM (2008) Optic disc hemorrhage may be associated with retinal nerve fiber loss in otherwise normal eyes. Ophthalmology 115:2132–2140

    Article  PubMed  Google Scholar 

  16. Lafuente MP, Villegas-Pérez MP, Sellés-Navarro I, Mayor-Torroglosa S, Miralles de Imperial J, Vidal-Sanz M (2002) Retinal ganglion cell death after acute retinal ischemia is an ongoing process whose severity and duration depends on the duration of the insult. Neuroscience 109:157–168

    Article  PubMed  CAS  Google Scholar 

  17. Zangwill LM, Bowd C (2006) Retinal nerve fiber layer analysis in the diagnosis of glaucoma. Curr Opin Ophthalmol 17:120–131

    PubMed  Google Scholar 

  18. Leung C, Choi N, Weinreb RN, Liu S, Ye C, Liu L, Lai GW, Lau J, Lam DSC (2010) Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography pattern of RNFL defects in glaucoma. Ophthalmology 117:2337–2344

    Article  PubMed  Google Scholar 

  19. Wolf-Schnurrbusch UEK, Enzmann V, Brinkmann CK, Wolf S (2008) Morphologic changes in patients with geographic atrophy assessed with a novel spectral OCT-SLO combination. Invest Ophthalmol Vis Sci 49:3095–3099

    Article  PubMed  Google Scholar 

  20. Menke MN, Dabov S, Knecht P, Sturm V (2009) Reproducibility of retinal thickness measurements in healthy subjects using spectralis optical coherence tomography. Am J Ophthalmol 147:467–472

    Article  PubMed  Google Scholar 

  21. Schiefer U, Pascual JP, Edmunds B, Feudner E, Hoffmann EM, Johnson CA, Lagrèze WA, Pfeiffer N, Sample PA, Staubach F, Weleber RG, Vonthein R, Krapp E, Paetzold J (2009) Comparison of the new perimetric GATE strategy with conventional full-threshold and SITA standard strategies. Invest Ophthalmol Vis Sci 50:488–494

    Article  PubMed  Google Scholar 

  22. Hermann A, Paetzold J, Vonthein R, Krapp E, Rauscher S, Schiefer U (2008) Age-dependent normative values for differential luminance sensitivity in automated static perimetry using the Octopus 101. Acta Ophthalmol 86:446–455

    Article  PubMed  Google Scholar 

  23. Jansonius NM, Nevalainen J, Selig B, Zangwill LM, Sample PA, Budde WM, Jonas JB, Lagrèze WA, Airaksinen PJ, Vonthein R, Levin LA, Paetzold J, Schiefer U (2009) A mathematical description of nerve fiber bundle trajectories and their variability in the human retina. Vision Res 49:2157–2163

    Article  PubMed  CAS  Google Scholar 

  24. Katz J, Sommer A, Gaasterland DE, Anderson DR (1991) Comparison of analytic algorithms for detecting glaucomatous visual field loss. Arch Ophthalmol 109:1684–1689

    Article  PubMed  CAS  Google Scholar 

  25. No authors listed (1994) Advanced Glaucoma Intervention Study. 2. Visual field test scoring and reliability. Ophthalmology 101: 1445–1455

    Google Scholar 

  26. Prata TS, De Moraes CGV, Teng CC, Tello C, Ritch R, Liebmann JM (2010) Factors affecting rates of visual field progression in glaucoma patients with optic disc hemorrhage. Ophthalmology 117:24–29

    Article  PubMed  Google Scholar 

  27. Kerrigan-Baumrind LA, Quigley HA, Pease ME, Kerrigan DF, Mitchell RS (2000) Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci 41:741–748

    PubMed  CAS  Google Scholar 

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Disclosure

Ulrich Schiefer is Consultant of Haag-Streit, Koenitz, Switzerland. He developed several perimetric strategies and holds patents in this field. The other authors report no conflicts of interest. The authors also have full control of all primary data and agree to allow the journal to review the data on request.

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Authors and Affiliations

  1. University Eye Hospital, Centre for Ophthalmology, University of Tuebingen, Schleichstr 12-16, 72076, Tuebingen, Germany

    Christoph Kernstock, Janko Dietzsch, Kai Januschowski, Ulrich Schiefer & M. Dominik Fischer

Authors
  1. Christoph Kernstock
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  2. Janko Dietzsch
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  3. Kai Januschowski
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  4. Ulrich Schiefer
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  5. M. Dominik Fischer
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Corresponding author

Correspondence to M. Dominik Fischer.

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Kernstock, C., Dietzsch, J., Januschowski, K. et al. Optical coherence tomography shows progressive local nerve fiber loss after disc hemorrhages in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 250, 583–587 (2012). https://doi.org/10.1007/s00417-011-1825-3

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  • DOI: https://doi.org/10.1007/s00417-011-1825-3

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