Cumulative Incidence of Patients with Disc Hemorrhages in Glaucoma and the Effect of Therapy

Hendrickx, Karin H.; Enden, Aad van den; Rasker, Marga T.; Hoyng, Ph F. J.

doi:10.1016/s0161-6420(94)31192-4

Cited by 87 publications

(72 citation statements)

References 19 publications

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“…On the other hand, there is evidence from other studies that lowering intraocular pressure in patients with POAG reduces the incidence of future optic disc hemorrhages. 19 The present study suggests that optic disc hemorrhage in the setting of OHT places patients at a higher risk of developing POAG, as does older age, thinner cornea, higher pattern standard deviation on automated perimetry, and larger vertical cup to disc ratio. Thus an optic disc hemorrhage should be included in the decision matrix about initiating treatment in a patient with ocular hypertension.…”

Section: Discussionmentioning

confidence: 51%

Detection and Prognostic Significance of Optic Disc Hemorrhages during the Ocular Hypertension Treatment Study

et al. 2006

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Purpose: To compare the rates of detection of optic disc hemorrhages by clinical examination and by review of optic disc photographs at the Optic Disc Reading Center (ODRC), to assess the incidence of and the predictive factors for disc hemorrhages in the annual disc photographs of the Ocular Hypertension Treatment Study (OHTS), and to determine whether optic disc hemorrhages predict the development of primary open-angle glaucoma (POAG) in the OHTS.Design: Cohort study.Participants: 3,236 eyes of 1,618 participants. Methods:Both eyes of participants were examined for optic disc hemorrhages every 6 months by clinical examination, with dilated fundus examinations every 12 months, and by annual review of stereoscopic disc photographs at the ODRC. Main Outcome Measures:Incidence of optic disc hemorrhages and POAG endpoints.Results: Median follow-up was 96.3 months. Stereophotograph-confirmed glaucomatous optic disc hemorrhages were detected in 128 eyes of 123 participants prior to POAG. Twenty one (16%) were detected by both clinical examination and review of photographs and 107 (84%) only by review of photographs (P <0.0001). Baseline factors associated with disc hemorrhages were older age, thinner corneas, larger vertical cup/disc ratio, larger PSD index on perimetry, family history of glaucoma, and smoking. The occurrence of a disc hemorrhage increased the risk of developing POAG 6-fold in a univariate analysis, (p<0.001; 95% confidence interval 3.6 -10.1), and 3.7-fold in a multivariate analysis that included baseline factors predictive of POAG (p<0.001; 95% confidence interval 2.1 -6.6). The 96-month cumulative incidence of POAG in the eyes without optic disc hemorrhage was 5.2% compared to 13.6% in the eyes with optic disc hemorrhage. In eyes with a disc hemorrhage that developed a POAG endpoint, the median time between the two events was 13 months.Corresponding Author: Donald L. Budenz, MD, MPH, Bascom Palmer Eye Institute, 900 NW 17th St, Miami, FL 33136. Telephone 305−326−6384. FAX 305−326−6337. E-mail: dbudenz@med.miami.edu Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion: Review of stereo photographs was more sensitive at detecting optic disc hemorrhage than clinical examination. The occurrence of an optic disc hemorrhage was associated with an increased risk of developing a POAG endpoint in participants in the OHTS. However, the majority of eyes (86.7%) that developed a disc hemorrhage have not developed a POAG endpoint to date.

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Section: Discussionmentioning

confidence: 51%

Detection and Prognostic Significance of Optic Disc Hemorrhages during the Ocular Hypertension Treatment Study

et al. 2006

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“…The reported prevalence of disc hemorrhages in normal individuals is quite low (∞1%) (Bengtsson et al 1981;Kitazawa et al 1986;Diehl et al 1990;Cockburn 1987;Bengtsson, 1990;Klein et al 1992;Healey et al 1998), and much more prevalent in primary openangle glaucoma and NTG (Bengtsson et al 1981;Susanna et al 1979;Gloster 1981;Shihab et al 1982;Kitazawa et al 1986;Drance 1989;Diehl et al 1990;Hendrickx et al 1994). The present study confirmed the strong association of disc hemorrhage with glaucomatous eye.…”

Section: Discussionmentioning

confidence: 99%

Disc hemorrhage and peripapillary atrophy in apparently healthy subjects

Sugiyama

Tomita

Kawase

et al. 1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: We estimated the prevalence of disc hemorrhage and peripapillary atrophy in apparently healthy subjects. Methods: We reviewed consecutive plain color fundus photographs of 12,140 eyes of 6,070 subjects (male/femaleΩ4,079/1,991) who visited a health consultation center. Results: We analyzed 11,934 eyes of 5,967 subjects with good quality of photographs. Disc hemorrhage was found in 36 eyes of 35 subjects (0.6%). The prevalence of disc hemorrhage was significantly greater in women 60 years of age or older (Fisher's exact test, pΩ0.0004). The prevalence of peripapillary atrophy (zone Beta, zone Alpha), and suspected glaucomatous excavation in eyes with disc hemorrhage was 66.7%, 86.1% and 25.0%, respectively, and significantly greater than that (29.1%, 52.9% and 1.7%) in eyes without disc hemorrhage (Fisher's exact test, p∞0.0001). Conclusions: Disc hemorrhage is more frequent in women over 60 years of age and is significantly associated with peripapillary atrophy in otherwise apparently healthy Japanese people.

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“…7 Elevated IOP being a major contributor of glaucoma and decreasing IOP will halt the disease process but in near about 30-40% of glaucoma Patients shows normal IOP. 8 Hence elevated IOP is main but not the only factor in development of glaucoma.…”

Section: Pathophysiology Of Glaucomamentioning

confidence: 99%

Preserved to preservative free prostaglandin analogues in primary open angle glaucoma

Morge

Kulkarni

Doifode

2013

Int J Basic Clin Pharmacol

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Cumulative Incidence of Patients with Disc Hemorrhages in Glaucoma and the Effect of Therapy

Cited by 87 publications

References 19 publications

Detection and Prognostic Significance of Optic Disc Hemorrhages during the Ocular Hypertension Treatment Study

Detection and Prognostic Significance of Optic Disc Hemorrhages during the Ocular Hypertension Treatment Study

Disc hemorrhage and peripapillary atrophy in apparently healthy subjects

Preserved to preservative free prostaglandin analogues in primary open angle glaucoma

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