The pathogenesis of optic disc splinter haemorrhages: a new hypothesis

Acta Ophthalmol Scand. 2006 Feb;84(1):62-8. doi: 10.1111/j.1600-0420.2005.00590.x.

Abstract

Purpose: To describe a hypothesized relationship between optic disc haemorrhages (ODHs) and primary vascular dysregulation (PVD).

Methods: Observational case report of a patient with classical PVD and five bilateral recurrent ODHs

Results: The ODHs were superotemporal in the right eye and inferotemporal in the left; the eyes were otherwise normal. Intraocular pressure (IOP) never exceeded 17 mmHg. Visual fields were normal. Increased blood flow resistivity, a reduced blood flow of the extraocular vessels, a low systemic blood pressure, a cold-induced flow stop of the nailfold capillaries, and elevated endothelin-1 plasma levels were found, all confirming the diagnosis of vascular dysregulation.

Conclusions: Optic disc haemorrhages may be due to a disturbed blood-retina barrier rather than to a mechanical rupture of the vessel. This barrier dysfunction may occur in the context of PVD.

Publication types

  • Case Reports

MeSH terms

  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • Blood-Retinal Barrier
  • Cold Temperature
  • Endothelin-1 / blood
  • Female
  • Humans
  • Intraocular Pressure / physiology
  • Middle Aged
  • Nails / blood supply
  • Optic Disk
  • Peripheral Vascular Diseases / complications*
  • Peripheral Vascular Diseases / physiopathology
  • Philosophy
  • Regional Blood Flow / physiology
  • Retinal Hemorrhage / etiology*
  • Retinal Hemorrhage / physiopathology
  • Visual Fields / physiology

Substances

  • Endothelin-1