Optic Disc Hemorrhage and Lamina Cribrosa Defects in Glaucoma Progression

Both disc hemorrhages (DH) and focal lamina cribrosa (LC) defects are recently considered as a progression factor in glaucoma. However, the clinical relevance of the presence of LC findings at the site of the DH has not yet been determined. We conducted a prospective study enrolling a total of 98 glaucoma eyes with DH and 37 OAG eyes with focal LC defect without DH to determine whether visual field (VF) progression differs according to the findings of the LC that had been evaluated by enhanced depth imaging (EDI) of optical coherence tomography (OCT) and its relationship with DH. Only the presence of focal LC defects was significantly different between the progressing and stable patients (P < 0.001). Baseline intraocular pressure (hazard ratio [HR], 1.076; P = 0.098) and the presence of focal LC defects at the DH site (HR, 2.620; P = 0.002) were found to be associated with VF progression. Glaucoma eyes with DH at the site of focal LC defects showed frequent and faster VF progression compared with DH not accompanied by LC alterations or LC alterations not accompanied by DH. Evaluating LC alterations in glaucoma eyes with DH may be important in predicting the progression of glaucoma.