Purpose To determine if a crowded nerve head and small scleral canal are involved in the pathogenetic mechanisms of idiopathic intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH). Design Prospective, observational case-control study.
Methods  Setting: institutional  Patients: Subjects with idiopathic IHAPSH diagnosed at Affiliated Ophthalmology Hospital, The First Clinical College of Harbin Medical University from 2005 to 2011 and age- and gender-matched myopic control subjects (n=10).Observation Procedures: In all subjects, the size of the inner aspect of the scleral canal and the characteristics of the optic nerve head were analyzed with Stratus Optical Coherence Tomography Optic Nerve Head Analysis software and manual segmentation software (which analyzed fundus images). The Mann-Whitney U-test and multiple comparisons (with the Bonferroni correction method) were performed. P values less than 0.002 (two-sided) were considered statistically significant.
Main Outcome Measures The area, diameter, and the area/diameter ratio of the optic disc, the vertical and horizontal diameter of the inner aspect of the scleral canal, the optic cup area, the vertical integrated rim area (VIRA), and the rim area.
Results The area, diameter, and diameter/area ratio of the optic disc and the horizontal diameter of the inner aspect of the scleral canal were significantly lower in the affected and contralateral eyes of the subjects with IHAPSH than in the eyes of the controls. Conversely, the IHAPSH-affected and contralateral eyes had significantly higher VIRA and rim area values than the control eyes. the VIRA, rim area, and the area of the inner aspect of the scleral canal were greater in the IHAPSH-affected eyes than in the contralateral eyes.
Conclusions Patients with idiopathic IHAPSH have smaller optic discs and scleral canals than control subjects, with a higher level of nerve fiber crowding.