Korean J Ophthalmol.  2007 Dec;21(4):222-227. 10.3341/kjo.2007.21.4.222.

Disc Hemorrhages in Patients with both Normal Tension Glaucoma and Branch Retinal Vein Occlusion in Different Eyes

• Yoo YC
• Park KH

• KMID: 754640
• DOI: http://doi.org/10.3341/kjo.2007.21.4.222

Abstract

PURPOSE: To document the clinical features of disc hemorrhage in patients with branch retinal vein occlusion (BRVO) and normal tension glaucoma (NTG), and to evaluate the relationship between BRVO and NTG with disc hemorrhages. METHODS: From July 2001 to May 2006, sixteen patients with both NTG and BRVO in different eyes were successively collected from outpatient population of Seoul National University Hospital in this observational case series. The frequency and location of disc hemorrhages, history of associated systemic diseases, and the order of the time of diagnosis between NTG and BRVO were studied. RESULTS: All patients had unilateral BRVO, and their mean age was 63.3+/-10.6 years. Disc hemorrhages were detected in eight patients (50%) during the mean follow-up of 26.8 months (range, 3-96 months). Six patients (75%) had disc hemorrhages in the non-BRVO eyes and two patients (25%) in BRVO eyes. Five hemorrhages (62.5%) were located at inferior-temporal quadrant of the optic disc. History of systemic hypertension was identified in 12 patients (75.0%). In 11 patients (68.8%), NTG was diagnosed at the same time as BRVO. CONCLUSIONS: A higher frequency of disc hemorrhages was identified in patients with both BRVO and NTG. Therefore, some cases of NTG, especially with disc hemorrhages, may share a common vascular pathophysiology with BRVO.

Keyword

Branch retinal vein occlusion; Disc hemorrhage; Normal tension glaucoma

MeSH Terms

Adult
Aged
Eye Hemorrhage/*etiology/pathology/physiopathology
Female
Fluorescein Angiography
Follow-Up Studies
Fundus Oculi
Glaucoma, Open-Angle/*complications/pathology/physiopathology
Humans
Intraocular Pressure
Male
Middle Aged
Optic Disk/*pathology
Optic Nerve Diseases/*etiology/pathology/physiopathology
Retinal Vein Occlusion/*complications/pathology
Retrospective Studies
Severity of Illness Index
Visual Acuity

Figure

• 

  Fig. 1 Retinal nerve fiber layer (RNFL) photographs of a 67 year-old female patient (Case 10). (A) Right eye shows a small wedge shape RNFL defect (arrowheads) with a disc hemorrhage (white arrow) at 11 o'clock of disc. (B) Left eye shows features of chronic phase branch retinal vein occlusion (BRVO), i.e., vascular sheathing, epiretinal membrane, and collateral vessels that note a previous event of BRVO at superior nasal quadrant of retina.

• 

  Fig. 2 Retinal nerve fiber layer (RNFL) photographs and fluorescein angiogram of a 73 year-old male patient (Case 1). (A) Right eye shows a small, splint hemorrhage at 7 o'clock of disc (white arrow), and vascular sheathing and retinal hemorrhages at superior temporal quadrant. Fluorescein angiography of right eye (inset picture), taken 3 months prior to RNFL photographies, shows a venous filling delay at superior temporal quadrant. (B) Left eye shows diffuse thinning of RNFL.

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