Clinical characteristics of glaucoma patients with disc hemorrhage in different locations

To compare the clinical characteristics and outcomes of eyes with unilateral disc hemorrhage (DH) in different locations.

This was a retrospective cohort study. DHs were classified by locations: the superior, superotemporal, inferotemporal, or inferior sectors of optic disc were classified as the susceptible area, while other sectors were defined as the less susceptible area. Structural and functional outcomes were analyzed by the Humphrey field analyzer and spectral domain optical coherence tomography.

Forty-three eyes with DHs in the susceptible area were less myopic and had more peripapillary-type DH, larger cup-to-disc ratio, cup volume, and disc area. Thirty-three eyes with DHs in the less susceptible area had less association with RNFL defects, greater tilted ratio, and less torsion of the disc. Follow-up revealed that the change in sectoral RNFL (μm) thickness was significantly greater for DHs in the susceptible area within one year (− 6.0 ± 14.0 vs. 0.7 ± 13.0, p = 0.035) and two years (− 10.0 ± 17.4 vs. − 1.1 ± 7.6, p = 0.012), while the change in average RNFL thickness was not different. Eyes with DHs in the susceptible area had faster MD deterioration (dB/year) than those in the less susceptible area within four years (− 0.32 ± 0.51 vs. − 0.05 ± 0.45, p = 0.047). A total of 16.9% of eyes, all in the susceptible area, had localized VF progression at DH corresponding area.

Disc hemorrhage in the superotemporal and inferotemporal regions had more subsequent structural and functional deterioration compared with the eyes with DHs in the temporal quadrant and nasal area.