Effect of Focal Lamina Cribrosa Defect on Disc Hemorrhage Area in Glaucoma

PURPOSE. The purpose of this study was to evaluate the association between focal lamina cribrosa defect (FLCD) and the topographic characteristics of disc hemorrhage (DH), including area and location. METHODS. We enrolled a total of 98 primary open-angle glaucoma eyes with DH (98 subjects). In vivo lamina cribrosa (LC) images were obtained by swept-source optical coherence tomography (SS-OCT) immediately following the detection of DH. Two masked graders identified FLCD (laminar holes or disinsertions >100 lm in diameter and >30 lm in depth), defined by a customized protocol using en face images and 12 radial-orientation raster scans of SS-OCT. En face image/stereo-disc photography overlay images were evaluated to determine the spatial relationship between the respective FLCD and DH locations. A method of comparing the disc area and DH area pixel numbers was used to estimate the DH area. RESULTS. Sixty-eight of 98 eyes with DH (68.4%) had at least one FLCD. Thirty-eight of those 68 eyes with DH and at least one FLCD (55.9%) had a DH corresponding to the FLCD location (within one-half clock-hour distance from the midline). The FLCD-correspondent DHs (39 DHs) showed significantly larger areas (0.092 6 0.030 mm2; P < 0.001) and more proximally located proximal ends (P < 0.028) than the noncorresponding ones (33 DHs; 0.065 +/- 0.024 mm2 of area). CONCLUSIONS. The DHs that correspond to FLCD location tend to have larger areas and to be more proximally located than those without correspondence. This suggests that FLCD might affect the topographic characteristics of DH.