Optic disk hemorrhages in glaucoma

Abstract

We evaluated the frequency and location of optic disk hemorrhages by examining morphometrically color stereo optic disk photographs of 1,505 glaucomatous eyes and 595 normal eyes. Disk hemorrhages were found in 61 of the glaucomatous eyes (4.1%) and in none of the normal eyes. The frequency of the hemorrhages increased from an early stage of glaucoma to a medium-advanced stage and decreased again toward a far-advanced stage. The disk hemorrhages were not found in disk regions or eyes without detectable neuroretinal rim. In early glaucoma, they were usually located in the inferotemporal or superior disk regions. (The frequency of hemorrhages was 6.3% in normal-pressure glaucoma, 4.9% in primary open-angle glaucoma, and 3.1% in secondary open-angle glaucoma). They were correlated with localized retinal nerve fiber layer defects, neuroretinal rim notches, and circumscribed perimetric loss. These characteristics imply the pathogenetic and diagnostic importance of disk hemorrhages for the detection of glaucoma.