Multilayered Optic Disc Hemorrhages in Adolescents

Hwang, Jiunn Feng; Lin, Chun Ju

doi:10.3928/01913913-20140715-01

Cited by 7 publications

(16 citation statements)

References 20 publications

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“…First, the coexistence of a crowded, tilted disc, [2,5,6,8] disc edema, [2,5] and high myopia [9,10] has been observed in previously published reports. Our series show similar results as crowded and edematous optic nerve head was found on fundoscopic examination and was further supported by similar findings on OCT in the cases this was performed in.…”

Section: Discussionmentioning

confidence: 79%

“…[1] These cases were distinct due to the significant bleeding within the optic disc that extends into the peripapillary subretinal space; in some cases, vitreous hemorrhage occurs too. It has been described more frequently in patients with myopia, small, mildly dysplastic, tilted optic discs [2][3][4][5][6][7][8] and in the young Asian population. [3][4][5]8] Despite the alarming appearance, a good visual prognosis has been documented where there is spontaneous resolution without intervention.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5]8] Despite the alarming appearance, a good visual prognosis has been documented where there is spontaneous resolution without intervention. [1][2][3][4][5][6][7][8] The cause of this condition is unknown. Vitreous traction on the optic disc during posterior vitreous detachment has been proposed as one possible cause for IHAPSH.…”

Section: Introductionmentioning

confidence: 99%

“…Vitreous traction on the optic disc during posterior vitreous detachment has been proposed as one possible cause for IHAPSH. [1][2][3]6] It has also been recognized as a subtype and consequence of Valsalva retinopathy. [5,6] The purpose of this study was to describe further the clinical characteristics associated with IHAPSH in adolescent Chinese.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in adolescents

Yan¹,

Brelén²,

Chen³

et al. 2019

cleverjournal

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Purpose: The purpose of this study was to report the clinical features of seven eyes of seven adolescent patients with spontaneous intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH). Design: This was a retrospective case series study. Participants: A total of seven adolescent patients with IHAPSH were participated. Methods: All the patients were seen at the Joint Shantou International Eye Centre, between 2006 and 2014. The patient demographics, clinical history, vision, fundoscopy, and results of relevant investigations were collected. Main Outcome Measures: This was a clinical history and fundoscopic appearance. Results: All eyes (four males and three females) with IHAPSH had a median age at presentation of 15 years (mean 14.7, range 11-19). Four cases presented in the right eye and three cases in the left eye. All seven patients presented with blurring of vision and floaters upon awakening in the morning. No obvious underlying causes or predisposing factors were present. The presenting visual acuity ranged from 0.12 to 1.00. One eye had no refractive errors and the remaining six eyes had myopia ranging mild to moderate (−0.25 diopters (D)-−4.00 D). None had tilted discs. In four eyes, subretinal hemorrhage was <2 disc diameters. There was associated vitreous hemorrhage in five eyes. There were no posterior vitreous detachments in any of the eyes. Visual field test showed an enlarged blind spot in four cases. Optical coherence tomography of the disc revealed optic disc swelling in two cases. Fluorescein angiography demonstrated leakage in the late phase of three eyes. At 2-24 months follow-up, the hemorrhage resolved in all seven cases with vision recovering fully to 20/20. Visual field defect of enlarged blind spots improved with the resolution of intrapapillary and subretinal hemorrhages. Conclusions: The condition of IHAPSH resolved spontaneously without intervention in all cases. There appeared to be no predisposing factors for the development of this condition. Previously reported risk factors such as myopia, a tilted disc, Valsalva maneuver, and posterior vitreous detachment were not seen in these cases. This is the 1 st time a series of young adults have been reported with this condition, all of whom presented in the same manner and had the same clinical outcomes.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Spontaneous intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in adolescents

Yan¹,

Brelén²,

Chen³

et al. 2019

cleverjournal

View full text Add to dashboard Cite

show abstract

“…This is illustrated by numerous publications investigating the relationship between vitreopapillary adhesion (VPA) and macular hole, diabetic retinal oedema, macular oedema associated with premacular membrane (PMM) and retinal vein occlusion (Chauhan et al 2000;Rumelt et al 2003;Karatas et al 2005;Sebag et al 2009;Wang et al 2009;Krebs et al 2011;Romano et al 2015;Sebag 2015). Furthermore, there are case reports suggesting that VPT could cause optic nerve head elevation and haemorrhages, and even visual field defects (Katz & Hoyt 1995;Wisotsky et al 1998;Kokame et al 2004;Sibony et al 2008;Nomura et al 2010;Wong et al 2012;Hwang & Lin 2014). Indeed, Kim et al (2014) reported significantly lower mean deviations (MD) on automated perimetry in PMM patients with VPT compared to those without.…”

Section: Introductionmentioning

confidence: 99%

The vitreopapillary interface in healthy and glaucoma: posterior vitreous detachment in the vitreopapillary interface study

Willekens

Pinto

Lemmens

et al. 2018

Acta Ophthalmologica

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Purpose To investigate the vitreopapillary interface (VPI) in health and glaucoma according to the different stages of posterior vitreous detachment (PVD) formation. Methods Prospective single centre study including healthy subjects and glaucoma patients. PVD staging was performed with spectral domain optical coherence tomography. Gender, age, lens status and refractive error were assessed in both groups. Glaucoma patients additionally had a comprehensive ophthalmological investigation including intraocular pressure measurement, visual field testing and confocal imaging of the optic nerve head. Results Data on 523 subjects (993 eyes) were included from the VPI study (clinicaltrials.gov NCT02290795) database (493 eyes of 258 healthy subjects and 500 eyes of 265 glaucoma patients). Healthy subjects were significantly younger than primary open angle glaucoma patients (59.7 ± 14.81 versus 70.0 ± 10.78 years, p < 0.001), but were otherwise matched for refractive error and gender. Significantly more glaucomatous eyes were pseudophakic (26.6% versus 5.1%). Including only phakic nonoperated eyes from subjects between 50 and 80 years old decreased the age difference between healthy and open angle glaucoma (64.1 ± 8.0 versus 65.9 ± 6.7 years, p = 0.051). Comparing these subgroups rendered similar average ages for PVD stages 0 and 4, in contrast to the significant older age for the glaucoma subgroup in stage 1 (64.1 ± 6.01 versus 61.4 ± 8.38 years, p < 0.001) and a trend towards significance in stage 3 (70.8 ± 69.8 versus 67.5 ± 5.92 years, p = 0.051). Conclusion The VPI study is a large clinical trial investigating the VPI in health and glaucoma. A subset of glaucoma patients seems to experience stages 1–3 of PVD formation at older age compared to healthy subjects.

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Congenital Optic Nerve Anomalies

Brodsky¹

2016

Pediatric Neuro-Ophthalmology

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Multilayered Optic Disc Hemorrhages in Adolescents

Abstract: Multilayered optic disc hemorrhages in adolescents more commonly affect myopic eyes with crowded and tilted discs. The visual outcome is excellent.

Cited by 7 publications

References 20 publications

Spontaneous intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in adolescents

Spontaneous intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in adolescents

The vitreopapillary interface in healthy and glaucoma: posterior vitreous detachment in the vitreopapillary interface study

Congenital Optic Nerve Anomalies

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