J GlaucomaJanuary 20211 citations

Progression of Parapapillary Choroidal Microvascular Dropout After Disc Hemorrhage in Glaucoma Patients: 2 Case Reports.

Lee Jong Sub, Lee Won June, Lim Han Woong, Seong Mincheol

View on PubMed DOI: 10.1097/IJG.0000000000001688

AI Summary

Two glaucoma cases showed microvascular dropout progression after disc hemorrhage, suggesting a potential link between these factors and glaucoma progression, warranting further study.

Abstract

Purpose

Microvasculature dropout (MvD) is a novel finding seen in optical coherence tomography angiography (OCTA), which is characterized by a localized dehiscence of the choriocapillaris in the parapapillary atrophy area. Disc hemorrhage (DH) is an important factor often associated with the development and especially progression of glaucoma. Here, we present 2 cases of MvD progression with DH.

Methods and results: Case 1: A 62-year-old female patient with normal tension glaucoma in both her eyes had recurrent DH at the inferior area of her right eye. A new DH was observed in the inferotemporal area of the right eye with MvD progression on OCTA in the same direction three months from the baseline.Case 2: A 57-year-old female patient with bilateral steroid-induced secondary glaucoma also had recurrent DH in her right eye. Four months from the baseline, DH occurred in the superotemporal and inferotemporal area of the right eye, and MvD was detected on OCTA in the superotemporal corresponding direction. After 19 months from the baseline, OCTA was repeated. The DH had resolved, but the superotemporal MvD persisted.

Conclusions

The 2 cases presented here are the first to report on the relationship between MvD progression and DH. MvD as visualized in OCTA imaging looks to be of clinical importance, and hopefully future studies will reveal the actual connection between MvD, DH, and glaucoma progression.

MeSH Terms

ChoroidFemaleGlaucomaGlaucoma, Open-AngleHumansIntraocular PressureMiddle AgedNerve FibersOptic DiskRetinal Ganglion CellsTomography, Optical CoherenceVisual Fields

Shields Classification

Ch. 4Optic Nerve, Retina, and Choroid

Ch. 11Chronic Open-Angle Glaucoma and Normal Tension Glaucoma

Ch. 23Steroid-Induced Glaucoma

Key Concepts3

In a 62-year-old female patient with normal tension glaucoma in both eyes, recurrent disc hemorrhage (DH) in the inferior area of her right eye was followed by a new DH in the inferotemporal area of the right eye with microvasculature dropout (MvD) progression on OCTA in the same direction three months from baseline.

PrognosisCase seriesCase Reportn=1 patientCh5Ch12

In a 57-year-old female patient with bilateral steroid-induced secondary glaucoma, recurrent disc hemorrhage (DH) occurred in the superotemporal and inferotemporal area of the right eye, and microvasculature dropout (MvD) was detected on OCTA in the superotemporal corresponding direction four months from baseline.

PrognosisCase seriesCase Reportn=1 patientCh5Ch24

In a 57-year-old female patient with bilateral steroid-induced secondary glaucoma, after 19 months from baseline, the disc hemorrhage (DH) had resolved, but the superotemporal microvasculature dropout (MvD) persisted.