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The pathogenesis of optic disc splinter haemorrhages: a new hypothesis

2006; Wiley; Volume: 84; Issue: 1 Linguagem: Inglês

10.1111/j.1600-0420.2005.00590.x

1600-0420

Matthias C. Grieshaber, Tobias Terhorst, Josef Flammer,

Child Abuse and Related Trauma

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.