Relationship between optic disc hemorrhage and corneal hysteresis

Objective: To determine the relationship between optic disc hemorrhage (DH) and corneal hysteresis (CH). Methods: Consecutive patients with prior or current photographic evidence of unilateral DH who had undergone CH measurement with the Ocular Response Analyzer (ORA; Reichert, Buffalo, NY) were enrolled. Eyes with a history of corneal disease, refractive surgery, or bilateral DH were excluded. Central corneal thickness (CCT), visual field data, 5 consecutive previous intraocular pressures (IOPs), and maximum documented peak IOP were obtained by chart review. Vertical cup-to-disc ratio (VCDR), the presence of neuroretinal rim notching, number of clock hours of beta zone parapapillary atrophy (beta PPA), and eye with greater beta PPA width were determined from photographs by 2 masked expert examiners. Results: We identified and analyzed 49 patients with photographically documented unilateral DH. Compared to fellow non-DH eyes, eyes with DH had lower CH (8.7 +/- 1.9 vs 9.2 +/- 1.7; p = 0.002), higher IOP (15.6 +/- 3.6 vs 14.3 +/- 4.1; p = 0.017), and greater VCDR (0.79 +/- 0.13 vs 0.68 +/- 0.23; p < 0.001), but were similar with respect to CCT, beta PPA extent, rim notching, peak IOP, and visual field damage (all p > 0.05). Using multivariate conditional logistic regression analysis, only CH (p = 0.012) and VCDR (p = 0.004) predicted the laterality of the DH. Conclusions: Lower CH and greater VCDR are independently associated with DH. This suggests that CH may be a structural biomarker for an abnormality of the optic nerve complex that may be associated with progressive glaucoma. Eyes in which DH were detected had lower CH.