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Progressive retinal nerve fibre layer thinning and choroidal microvasculature dropout at the location of disc haemorrhage in glaucoma
  1. Chung Young Kim1,
  2. Eun Ji Lee1,
  3. Ji-Ah Kim1,
  4. Hyunjoong Kim2,
  5. Tae-Woo Kim1
  1. 1 Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  2. 2 Department of Applied Statistics, Yonsei University, Seoul, Korea
  1. Correspondence to Eun Ji Lee, Department of Ophthalmology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam 13620, South Korea; opticdisc{at}


Background/Aims To investigate whether parapapillary choroidal microvasculature dropout (MvD) is associated with progressive retinal nerve fibre layer (RNFL) thinning in eyes with primary open-angle glaucoma (POAG) and disc haemorrhage (DH).

Methods Parapapillary microvasculature was evaluated by swept-source optical coherence tomography (OCT) angiography (OCTA) in 50 eyes with POAG and DH, 1 year before, at the time of and 1 year after the detection of DH. MvD was defined as an area in the parapapillary deep layer of focal sectoral dropout with no visible microvascular network. Progressive changes in OCT RNFL thickness were compared in groups of eyes with and without MvD.

Results Cumulative prevalence of MvD was 76.0% (38 eyes) at 1 year after detection of DH. All MvDs were detected in the same sectoral locations as DH. In eyes with MvD, global RNFL thickness and sectoral RNFL thickness at the location of DH were significantly reduced, both from 1 year before to the time of DH detection (both p<0.001) and from DH detection to 1 year later (both p<0.001). In eyes without MvD, however, the reductions in global (p=0.011) and sectoral (p=0.007) RNFL thickness were significant only from DH detection to 1 year later.

Conclusion In eyes with POAG, RNFL thinning was spatially consistent and progressive at the location of MvD accompanied by subsequent DH and continued to progress after the occurrence of DH. When DH was not accompanied by MvD, progressive RNFL thinning was more likely to occur after the detection of DH.

  • Glaucoma
  • Optic Nerve
  • Imaging
  • Diagnostic tests/Investigation

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  • Contributors All authors contributed to the study concept and design, acquisition, analysis or interpretation of data and critical revision of the manuscript. CYK and EJL drafted the manuscript. CYK, EJL, HK contributed to the statistical analysis. EJL had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding None of the authors have proprietary or commercial interest in any of the materials discussed in this article. This work was supported by the Seoul National University Bundang Hospital Research Fund (no. 02-2016-023) and by Basic Science Research programme through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (No. 2016R1D1A1B02011696). The funders had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Data sharing statement Data are available upon reasonable request.

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

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