A 65-year-old woman with normal-tension glaucoma has progressive visual field loss despite IOP of 14 mmHg bilaterally on treatment. On fundoscopy, which finding is most characteristically associated with progression in this subtype of glaucoma?
- A Drusen at the macula
- B Splinter disc hemorrhages ✓
- C Cotton wool spots
- D Retinal neovascularization
Correct answer: B. Splinter disc hemorrhages
Explanation
Splinter or Drance hemorrhages at the optic disc margin are a hallmark finding in normal-tension glaucoma and are strongly associated with disease progression. These flame-shaped or splinter hemorrhages typically resolve within weeks to months and may recur. They reflect ongoing optic nerve head ischemia and lamina cribrosa damage independent of elevated IOP. Drusen, cotton wool spots, and neovascularization are unrelated to glaucoma progression.
Reference: The Glaucoma Book, 2010 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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