To evaluate the correlations of sympathetic variability and recurrent disc hemorrhage, and the morphology of the optic disc.

This study included 41 eyes of 41 patients who had at least one disc hemorrhage (DH), who were diagnosed with open-angle glaucoma or suspected glaucoma. All eyes had a DH at presentation and were followed-up for at least 3 years. Eyes were classified by the morphology of the optic disc into the focal rim thinning, concentric cupping, or myopic disc groups. The variability of the sympathetic nervous system was defined by the Standard deviation of all node to node intervals (SDNN) as very low frequency, low frequency (LF), or high frequency, which was the standard parameter of heart rate variabilities.

There were 14 (34.14%) eyes with a single DH, and the remaining eyes with a recurrent DH. Single DH patients tended to have a myopic disc ( p < 0.001) and, especially in the lower 50% of the SDNN group, the recurrent DH group had a lower SDNN ( p = 0.046), and a higher LF ( p = 0.002).

DH recurred when patients had morphological glaucomatous changes, especially focal rim thinning. Differences of the sympathetic variability had a strong correlation with the recurrent DH.