Grieshaber MC, Terhorst T, Flammer J. The pathogenesis of optic disc splinter haemorrhages: a new hypothesis.
ACTA ACUST UNITED AC 2006;
84:62-8. [PMID:
16445441 DOI:
10.1111/j.1600-0420.2005.00590.x]
[Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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.
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