Optic-disc hemorrhages: Cause or result of ischemia?

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Abstract
Visual-field defects may develop after optic-disc hemorrhages. The question whether blood may be a major damaging agent for the optic nerve head will be discussed. A female patient with an optic-disc hemorrhage in the left eye was followed with frequent disc photography and computerized perimetry for a period of two months. This patient presented, subsequently to an optic-disc hemorrhage of unknown cause, a delayed progression of the visual-field defect. The fact that the visual-field defect developed after the hemorrhage and was progressive in the next few days indicates that the hemorrhage may not be the result of an infarct, but rather provokes further damage. The case raises the question whether blood components may be involved in the pathophysiologic process of optic-nerve-head atrophy. In analogy of cerebral vasospasm after subarachnoid hemorrhage as an important cause of cerebral ischemia, the potential involvement of blood-related injury to the optic disc should be considered in such patients.

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