Active site hypothesis for progression of glaucomatous optic neuropathy and optic disc hemorrhage, and research for prediction of progression

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To elucidate the pathogenesis of glaucoma progression, we measured retinal nerve fiber layer defects (RNFLD) angles and divided normal-tension glaucoma (NTG) cases into 2 groups, enlarged RNFLD and stable RNFLD. Disc hemorrhages were found significantly more frequent in the enlarged group than in the stable group. RNFLD enlarged in the direction of disc hemorrhage in over 80% of eyes. In majority of eyes of the enlarged group, the enlargement of RNFLD was toward the fovea. The enlargement of RNFLD in NTG was closely associated with disc hemorrhage occurrence and the deterioration of visual field.