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Association between focal lamina cribrosa defects and optic disc haemorrhage in glaucoma
  1. Vijay Mistry1,2,
  2. Dong An2,
  3. Christopher J Barry2,
  4. Philip H House2,
  5. William H Morgan2,3
  1. 1 Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  2. 2 Center for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
  3. 3 Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Vijay Mistry, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; vjmis3{at}gmail.com

Abstract

Background/aims To explore the relationship between focal lamina defect (LD) size and optic disc haemorrhages (DH) in glaucomatous eyes.

Methods Radial B-scan images at 15° intervals obtained using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (OCT) were performed on a group of subjects previously assessed for DH every 3 months over a period of 5 years. EDI-OCT scans were assessed for the presence of focal lamina cribrosa defects by a single observer.

Results 119 eyes from 62 subjects (44 females, 18 males) were analysed. 44 eyes (37%) were noted to have at least 1 LD, and of those, eight eyes had more than one defect. 68 eyes (57%) were observed to have at least one DH occur over the course of monitoring. 48 eyes (40%) had recurrent DH, with a mean of 5.17 haemorrhages over the 5-year period. Type 1 focal LD (p=0.0000, OR 7.17), glaucoma progression (p=0.0024, OR 0.32) and ArtDiff (p=0.0466, OR 1.04) were significantly associated as predictors of DH. No correlation between the size of the LD and DH occurrence (p=0.6449, Spearman rank correlation) was found.

Conclusion Focal lamina cribrosa hole-type defects were significantly associated with an increase in DH occurrence over the preceding 5 years. The lack of association between defect size and DH suggests that DH and lamina defects may have separate links to the glaucomatous process.

  • glaucoma
  • lamina cribrosa
  • lamina defects
  • optic disc haemorrhage

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Footnotes

  • Contributors Conceptualisation: PHH and WHM. Investigation: all authors. Methodology: all authors. Data curation: VM, DA, PHH and WHM. Formal analysis: VM and WHM. Supervision: PHH and WHM.

  • Funding This work was supported by the National Health and Medical Research Council (NHMRC). NHMRC Grant Reference Number APP1020367 WHM, NHMRC Project Grant 102367 WHM and NHMRC Development Grant 107310 WHM.

  • Disclaimer The sponsor had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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