Recent Structural Alteration of the Peripheral Lamina Cribrosa Near the Location of Disc Hemorrhage in Glaucoma

PURPOSE: We investigated whether disc hemorrhage (DH) is associated with the recent structural alteration of the peripheral lamina cribrosa (LC) as assessed by enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT). METHODS: Serial horizontal B-scan images were obtained by EDI SD-OCT from primary open-angle glaucoma (POAG) patients before and after the detection of DH (DH group, n = 45), and those who had no DH during the 1-year scan interval (non-DH group, n = 36). The images were processed using compensation and contrast enhancement. Then, 11 radial OCT images centered on the optic disc were generated from the 3-dimensionally reconstructed volume image. A recent structural alteration of the LC was defined when either the outward deformation of the anterior LC surface or radial disruption of the LC was identified in the temporal periphery. RESULTS: A recent structural alteration of the LC was found in 40 (88.9%) eyes in the DH group versus 4 (11.1%) eyes in the non-DH group. The amount of maximum outward deformation (55.82 ± 34.60 vs. 20.15 ± 4.28 μm) and radial disruption (69.87 ± 46.74 vs. 18.31 ± 1.17 μm) was larger in the DH group than in the non-DH group. The maximum LC alteration was observed within 1 clock-hour distance from the location of DH in all 40 eyes. CONCLUSIONS: The peripheral LC exhibited a recent alteration in eyes with DH. The alteration was correlated spatially with the location of the DH. These findings suggest that DH may result from microvascular damage incurred from alteration of the LC near its insertion.