Optic Disc Hemorrhages in Glaucoma

Abstract

Optic disc hemorrhages are a significant clinical sign seen in patients with glaucoma and often herald glaucomatous progression. Longitudinal and population-based studies have shown that disc hemorrhages are most commonly seen in glaucoma, particularly normal tension glaucoma patients. The exact pathophysiology of an optic disc hemorrhage is not completely understood, but both mechanical rupture and vascular dysregulation theories have been proposed. Recent studies using spectral domain optic coherence tomography and visual field progression analysis have highlighted that structural and functional loss both precede and follow detection of an optic disc hemorrhage. The relationship between intraocular pressure and disc hemorrhages is not completely understood as some patients with disc hemorrhages may progress independent of intraocular pressure lowering therapy.