Changes in Retinal Nerve Fiber Layer Thickness After Optic Disc Hemorrhage in Glaucomatous Eyes

Purpose: The aim of this study was to investigate the changes in longitudinal retinal nerve fiber layer thickness (RNFLT) as determined by spectral-domain optical coherence tomography (OCT) after optic disc hemorrhage (DH) in glaucomatous eyes. Methods: A total of 65 eyes with unilateral DH and 65 contralateral eyes without DH were subjected to RNFLT measurements by using OCT at the time of DH detection and at 1 year (12 +/- 2 mo) and 2 years (24 +/- 2 mo) later. For the definition of event-based significant RNFLT changes (a change beyond the upper limit of the 95% confidence interval of test-retest variability), 50 eyes with stable glaucoma without DH that had undergone OCT examinations 3 times with a 1-year interval were also enrolled. Clock-hour sector RNFLT in the eyes with DH and clock-hour sector RNFLT at equivalent locations in the contralateral eyes without DH were analyzed to assess localized and spatially compatible RNFLT changes associated with DH. Results: Of the eyes with DH, 38.5% showed decrease in RNFLT and 6.2% showed increase in RNFLT 1 year after DH detection, whereas 58.5% showed decrease in RNFLT and no eye showed increase in RNFLT 2 years after DH detection. Significant decreases in RNFLT in the eyes with DH were associated with the presence of recurrent DH and greater baseline RNFLT (P < 0.05). Of the contralateral eyes without DH, 4.6% and 15.4% showed decrease in RNFLT 1 and 2 years after DH detection, respectively. Conclusions: In the glaucomatous eyes, DH was associated with progressive decrease in RNFLT as determined by OCT, especially in the eyes with recurrent DH and greater baseline RNFLT.