Optic Disc Hemorrhage Is Not Associated with Global Choroidal Vessel Loss, but Is Associated with Localized Choroidal Vessel Loss in Glaucoma

Abstract

Purpose: To investigate the relationship between optic disc hemorrhage (ODH) and the geographic pattern (regional vs. global) of parapapillary choroidal vessel density (pCVD) loss within the β-parapapillary atrophy (β-PPA) in open-angle glaucoma (OAG) Methods: This retrospective cross-sectional study included 100 OAG eyes with visual field (VF) defects confined to a single hemifield (50 with and 50 without ODH, matched for age (≤10 years) and VF severity (≤1 decibel) at the same hemifield), as well as 50 healthy eyes. The pCVD was measured using optical coherence tomography angiography (OCTA). The relationships between pCVD and clinical factors were assessed globally and regionally. Logistic regression analyses were performed to determine the clinical factors associated with the presence of ODH. Results: The pCVD values within ODH-affected hemiretinae of ODH+ eyes were significantly lower than those in the matched hemiretinae of ODH− eyes (p = 0.001). The presence of ODH was significantly correlated with a lower pCVD within ODH-dominant inferior hemiretinae (p < 0.05). Lower pCVD values at ODH-affected hemiretinae was significantly associated with the presence of ODH (p < 0.05). Conclusions: OAG eyes with ODH demonstrate a greater severity of regional pCVD loss at the hemiretinae spatially corresponding to the ODH location compared to OAG eyes without ODH.

Quantification of localised vascular wedge‐shaped defects in glaucoma

“…Similarly, LeTran observed a strong relationship between DH history and vascular wedge defects, with 65% of POAG eyes with both vascular wedges and DH having hemispheric concordance of these events 11 . Lee et al observed increased choroidal vessel density loss in localised regions which spatially corresponded to DH location in POAG eyes 22 . Further, Nishida et al observed in a longitudinal study that DH presence was a predictor of faster vessel density loss 23 .…”

“…11 Lee et al observed increased choroidal vessel density loss in localised regions which spatially corresponded to DH location in POAG eyes. 22 Further, Nishida et al observed in a longitudinal study that DH presence was a predictor of faster vessel density loss. 23 DH presence has long been established as being associated with glaucoma progression, despite this, the underlying link in pathology is still in debate.…”