The pathogenesis of optic disc splinter haemorrhages: a new hypothesis.
OBJECTIVE
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.
Grieshaber
Matthias C
MC
University Eye Clinic, University Hospital of Basel, Basel, Switzerland.
Terhorst
Tobias
T
Flammer
Josef
J
D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001813:Blood-Retinal Barrier; D003080:Cold Temperature; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008875:Middle Aged; D009262:Nails / Q000098:blood supply; D009898:Optic Disk; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000503:physiopathology; D010684:Philosophy; D012039:Regional Blood Flow / Q000502:physiology; D012166:Retinal Hemorrhage / Q000209:etiology* / Q000503:physiopathology; D014794:Visual Fields / Q000502:physiology
D019332:Endothelin-1