Drance Hemorrhages
๐๐ฑ๐ต๐ช๐ค ๐๐ช๐ด๐ค ๐๐ฆ๐ฎ๐ฐ๐ณ๐ณ๐ฉ๐ข๐จ๐ฆ๐ดโฃ โฃ
โ Splinter or flame-shaped hemorrhages
โ Perpendicular to the optic disc marginโฃ
โ Classically, these hemorrhages are located in the prelaminar optic disc, cross the peripapillary zone, and extend into the adjacent superficial retinal nerve fiber layerโฃ โฃ
โ Disc hemorrhages are a risk factor for progression of glaucomaโฃ
โ Most common in normal tension glaucomaโฃ
โ Associated with notching of the neuroretinal rim or retinal nerve fibre layer defectsโฃ
๐๐๐ญ๐ก๐จ๐ ๐๐ง๐๐ฌ๐ข๐ฌ: โฃ โฃ
๐๐ฆ๐ค๐ฉ๐ข๐ฏ๐ช๐ค๐ข๐ญ ๐๐ฉ๐ฆ๐ฐ๐ณ๐บ:โฃ .โฃ
โ Disc hemorrhages result from mechanical shearing at the lamina cribrosa or because of damage to the capillary network at the border of retinal nerve fibre layer defect enlargement.โฃ
โ Primary insult is neurodegenerative, and the hemorrhage is a secondary event resulting from tissue damage.โฃ โฃ
๐๐ข๐ด๐ค๐ถ๐ญ๐ข๐ณ ๐๐ฉ๐ฆ๐ฐ๐ณ๐บ:โฃ โฃ
โ Ischemic microinfarction in the optic nerve head or break down of the blood-retinal barrier.โฃ โฃ
๐๐ฐ๐ค๐ข๐ต๐ช๐ฐ๐ฏ:โฃ โฃ Disc hemorrhages associated with glaucoma are found mostly in the inferotemporal and superotemporal regions of the optic discโฃ โฃ
๐๐บ๐ด๐ต๐ฆ๐ฎ๐ช๐ค ๐ข๐ด๐ด๐ฐ๐ค๐ช๐ข๐ต๐ช๐ฐ๐ฏ๐ด:โฃ โฃ
โ Hypertensionโฃ
โ Vascular diseaseโฃ
โ Migraineโฃ
โ Diabetesโฃ
โ Aspirin useโฃ
โ Smokingโฃ
โ Exfoliation syndrome etc.โฃ โฃ
๐๐ณ๐ฆ๐ข๐ต๐ฎ๐ฆ๐ฏ๐ต:โฃ โฃ
A disc hemorrhage does not need to be treated but its presence may signal the need for better control of intraocular pressure in glaucomatous eyes.โฃ
โฃ www.ophthalmobytes.comโฃ
Image from Rajan Eye Care Hospital
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