| 본문 : Purpose: To describe the clinical features of hemorrhagic complications secondary to optic nerve head drusen (ONHD) using spectral-domain optical coherence tomography (SD-OCT).
Design: Retrospective case series.
Methods
Setting Institutional
Patient: Sixty-three patients with ONHD.
Observation procedure: Patient demographics, presenting symptoms, visual acuity, fundus photographs, and SD-OCT findings were analyzed. In selected cases, fluorescein and indocyanine green angiography were performed.
Main outcome measures: Clinical features of hemorrhagic ONHD complications, including SD-OCT findings.
Results: Hemorrhagic ONHD complications were found in seven eyes (7%) from total 101 eyes with ONHD. All of them had myopia and buried ONHD. Patients with ONHD hemorrhagic complications had smaller disc diameter than patients without hemorrhagic complications (1307.50 ± 166.18 μm vs. 1555.33 ± 217.44 μm, p = 0.004, Mann–Whitney U test). Except for one patient, where ONHD were detected on routine examination, all patients complained of sudden vision blurring. All patients denied a history of trauma or past medical illness. Peripapillary hemorrhages were classified into the following three types based on SD-OCT findings: subretinal hemorrhage (n = 6 eyes, 86%), intraretinal or retinal nerve fiber layer hemorrhage (n = 5 eyes, 71%) and vitreous hemorrhage (n = 4 eyes, 57%). Follow-up examinations were performed in three patients. After one month, most hemorrhages were absorbed without complications.
Conclusions: Peripapillary hemorrhage can occur in patients with buried ONHD and small disc diameters. SD-OCT can visualize ONHD and is helpful in differential diagnosis of peripapillary hemorrhage and determining the position of hemorrhage within the retina. |