Association between focal lamina cribrosa defects and optic disc haemorrhage in glaucoma

Br J Ophthalmol. 2020 Jan;104(1):98-103. doi: 10.1136/bjophthalmol-2018-313775. Epub 2019 Apr 25.

Abstract

Background/aims: To explore the relationship between focal lamina defect (LD) size and optic disc haemorrhages (DH) in glaucomatous eyes.

Methods: Radial B-scan images at 15° intervals obtained using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (OCT) were performed on a group of subjects previously assessed for DH every 3 months over a period of 5 years. EDI-OCT scans were assessed for the presence of focal lamina cribrosa defects by a single observer.

Results: 119 eyes from 62 subjects (44 females, 18 males) were analysed. 44 eyes (37%) were noted to have at least 1 LD, and of those, eight eyes had more than one defect. 68 eyes (57%) were observed to have at least one DH occur over the course of monitoring. 48 eyes (40%) had recurrent DH, with a mean of 5.17 haemorrhages over the 5-year period. Type 1 focal LD (p=0.0000, OR 7.17), glaucoma progression (p=0.0024, OR 0.32) and ArtDiff (p=0.0466, OR 1.04) were significantly associated as predictors of DH. No correlation between the size of the LD and DH occurrence (p=0.6449, Spearman rank correlation) was found.

Conclusion: Focal lamina cribrosa hole-type defects were significantly associated with an increase in DH occurrence over the preceding 5 years. The lack of association between defect size and DH suggests that DH and lamina defects may have separate links to the glaucomatous process.

Keywords: glaucoma; lamina cribrosa; lamina defects; optic disc haemorrhage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glaucoma / diagnostic imaging
  • Glaucoma / etiology*
  • Glaucoma / pathology
  • Glaucoma / physiopathology
  • Humans
  • Imaging, Three-Dimensional / methods
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Optic Disk / diagnostic imaging
  • Optic Disk / pathology*
  • Optic Nerve Diseases / complications*
  • Optic Nerve Diseases / diagnostic imaging
  • Optic Nerve Diseases / pathology
  • Recurrence
  • Retinal Hemorrhage / complications*
  • Retinal Hemorrhage / diagnostic imaging
  • Retinal Hemorrhage / pathology
  • Tomography, Optical Coherence / methods
  • Visual Fields / physiology