title: The pathogenesis of optic disc splinter haemorrhages: a new hypothesis.
abstract: 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.
authors.affiliation: University Eye Clinic, University Hospital of Basel, Basel, Switzerland.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Grieshaber
authors.forename: Tobias
authors.initials: T
authors.lastname: Terhorst
authors.forename: Josef
authors.initials: J
authors.lastname: Flammer
mesh_terms: 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
chemical_list: D019332:Endothelin-1