Rates of Circumpapillary Retinal Nerve Fiber Layer Thinning and Capillary Density Loss in Glaucomatous Eyes with Disc Hemorrhage.

PURPOSE To investigate longitudinal changes in rates of optic nerve head circumpapillary retinal nerve fiber layer (cpRNFL) thinning and vessel density loss in primary open angle glaucoma (POAG) with or without history of disc hemorrhage (DH). DESIGN Observational cohort METHODS: In this longitudinal study, 34 eyes with DH and 134 eyes without DH that had at least 1.5 years of follow-up and three OCT and OCTA follow-up scans were enrolled. A linear mixed-effect model was used to compare the rates of cpRNFL thinning and vessel density loss between DH and non-DH eyes. RESULTS Rates of whole image capillary density (wiCD) loss were faster in the DH group compared to non-DH group (mean difference (95% CI): -0.32 (-0.59,-0.04) %/year, P=0.027). Faster mean rates of vessel density loss were found in the inferotemporal, inferonasal, and nasal sectors in eyes with DH than without DH (P<0.05). There was no statistically significant difference in the global rate of cpRNFL thinning between the two groups (P=0.679). The mean rate of cpRNFL thinning was faster in the DH group compared to the non-DH group only in the inferotemporal sector (mean difference (95% CI): -1.01 (-1.62,-0.40) μm/year; P=0.001). CONCLUSIONS Mean rates of vessel density loss between DH and non-DH eyes were different not only in the affected area but also in the other regions. In contrast, a significant difference in cpRNFL thinning between the two groups was detected only in the inferotemporal sector. Disc hemorrhage is an independent predictor of faster vessel density loss in glaucoma suspects and POAG patients.