Changed retinal capillary flow in patients with disc haemorrhages

Abstract

Abstract Purpose: Vascular pathogenesis in glaucoma has been recognized and optic disc haemorrhages (DH) may pre‐cede nerve fiber damage in glaucoma. The change in peripapillary retinal capillary flow after resorbtion of DH was investigated. Methods: Included were 25 eyes of 25 patients with DH. 17 eyes had glaucoma. Peripapillary retinal capillary flow was measured with the Heidelberg Retina Flowmeter in arbitrary units (AU). The first measure‐ment was made right after diagnosis of DH and the second six months later. Automatic full field perfu‐sion image analyser was used for analysis. Mean flow (MF), peak systolic flow (SF), and minimum dia‐stolic flow (DF) were measured, and pulsation index (PI) calculated. Flow values are reported from the whole temporal peripapillary retina (Area 1), the same horizontal level as the DH (Area 2), and from the area specifically around the DH (Area 3). Results: A significant increase in MF after resorbtion of DH was detected in Area 1 (median 263 AU, range 188 – 561 AU, vs. 328 AU, 199 – 462 AU; P = 0.008), and Area 2 (255 AU, 166 – 386 AU, vs. 330 AU, 198 – 646 AU; P=0.04). The increase in MF in Area 3 was of borderline significance (342 AU, 230 – 513 AU, vs. 402 AU, 200 – 629 AU; P = 0.10), as was the increase in SF in Area 2 (334 AU, 187 – 486 AU, vs. 400 AU, 227 – 690 AU; P = 0.07). No significant changes in DF or PI were found. Conclusions: Increase in retinal capillary flow after resorbtion of DH suggests a generalized decrease in retinal flow at the time DH is detected, or a compensatory increase after ischemia.