Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma

Ishida, Kyoko; Yamamoto, Tetsuya; Sugiyama, Kazuhisa; Kitazawa, Yoshiaki

doi:10.1016/s0002-9394(00)00441-4

Cited by 181 publications

(141 citation statements)

References 31 publications

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“…This finding concurs with the earlier report suggesting that border of RNFL defect is the most active site of the loss of retinal ganglion cells and their axons. 13 Pattern of progression of visual field defect was compatible with that of RNFL defect on red-free funds photographs: deepening or extension of the pre-existing scotoma and a new scotoma not within or adjacent to the existing scotoma. 11 Among six eyes that showed progression on the Humphrey central 30-2 threshold visual field or on the Humphrey Matrix 30-2 visual field, five eyes had compatible pattern of progression with that on red-free fundus photographs.…”

Section: Discussionmentioning

confidence: 64%

Patterns of progression of localized retinal nerve fibre layer defect on red-free fundus photographs in normal-tension glaucoma

Kim

et al. 2009

Eye

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Purposes To investigate patterns of progression of localized retinal nerve fibre layer (RNFL) defect on red-free fundus photographs and to quantify extents of progression in normal-tension glaucoma (NTG) patients. Methods Sixty-five eyes of consecutive 65 NTG patients who had shown progression of localized RNFL defect on serial red-free fundus photographs were selected for this study. Patterns of progression of localized RNFL defect on red-free fundus photographs were categorized and extents of progression were quantified. Serial assessments of disc stereophotographs and visual fields were also performed to detect progression. Results The most common pattern of progression was widening of the defect towards the macula (n ¼ 37; 56.9%) followed by deepening of the defect (n ¼ 25; 38.5%), appearance of a new defect (n ¼ 6; 9.2%), and widening of the defect away from the macula (n ¼ 5; 7.7%). Eight eyes simultaneously showed two patterns of progression. Mean angular widening of the defect towards the macula and away from the macula was 6.4±4.11 (range: 1.1-17.11, n ¼ 37) and 3.4±2.11 (range: 1.1-5.21, n ¼ 5), respectively. No progression was observed on the disc stereophotographs (n ¼ 65) or in the visual fields (n ¼ 55) in 64 eyes (98.5%) and 46 eyes (83.6%), respectively. Conclusions There were four patterns of progression of localized RNFL defect. In most cases, RNFL loss proceeded temporally.

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Section: Discussionmentioning

confidence: 64%

Patterns of progression of localized retinal nerve fibre layer defect on red-free fundus photographs in normal-tension glaucoma

Kim

et al. 2009

Eye

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“…Extrapolating the results obtained in NTG eyes with IOP of 16-17 mmHg (Collaborative NormalTension Glaucoma Study Group 1998; Leske et al 2007), many of these patients are currently treated with ocular hypotensive eye drops. Regarding prognostic factors in eyes with low-normal IOP under treatment, only two retrospective studies (Ishida et al 1998(Ishida et al , 2000 are available, and systemic and local vascular factors including high BP or disc haemorrhage, older age, absence of treatment with calcium channel blocker, worse VF or greater fluctuation of 24-hr IOP were reported as negative prognostic factors.…”

Section: Risk Factors For Progression Of Normal-tension Glaucoma Undementioning

confidence: 99%

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

Araie

Shirato²,

Yamazaki

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To prospectively study prognostic factors for normal-tension glaucoma (NTG) under treatment with topical b-blocker. Methods: One hundred and forty-six eyes of 146 patients with NTG with a mean untreated intraocular pressure (IOP) of 14 mmHg, mild to moderate visual field damage and mean spherical equivalent refraction of )3.5 ()8.0 to +2.0) dioptre were randomized to topical nipradilol or timolol and followed for 3 years. The Humphrey full threshold 30-2 visual field test was performed every 6 months, and optic disc photographs were obtained every 12 months. Progression was defined as visual field progression, optic disc and ⁄ or peripapillary nerve fibre layer change, and factors relating to progression were evaluated using Cox proportional hazards models. Results: IOP decreased by 1.0 mmHg over the 3-year period, during which 35% showed progression according to the aforementioned criteria. Optic disc haemorrhage (hazard ratio [HR] 4.00, p < 0.001) and less extent of myopia (per dioptre, HR 1.15, p = 0.013) were significant risk factors. When progression was defined by visual field progression only, less extent of myopia was again a significant risk factor (HR 1.17, p = 0.038). Conclusion: Beside optic disc haemorrhage, less extent of myopia was a risk factor for progression in the current NTG population where most patients were mildly myopic and IOP during follow-up averaged 13.2 mmHg under topical b-blocker.

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“…1 The haemorrhage typically shows a flame-or splinter-like shape at the border of the optic disc. 2,3 In early glaucoma, haemorrhage is usually located in inferotemporal or superotemporal optic disc regions.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma

et al. 2009

Eye

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Purpose To evaluate the risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma (NTG). Patients and methods Two hundred and eighty-one eyes of 281 patients with NTG (113 eyes with optic disc haemorrhage and 168 eyes without haemorrhage) were included in this study. Associations between optic disc haemorrhage and various patient-related variables (diabetes; hypertension; hypotension; cardiac disease; stroke; cold hand; migraine; constipation; use of steroids, aspirin, anticoagulant, or gingko extract; smoking history; and glaucoma family history) and eye-related variables (baseline intraocular pressure (IOP); maximum, minimum, and range of IOP; vertical and horizontal cup/disc ratio; mean deviation and pattern standard deviation of the visual field; corneal thickness; and average retinal nerve fibre layer (RNFL) thickness measured by optical coherence tomography) were investigated by univariate and multivariate logistic regression analyses. Differences in risk factors between patients with single optic disc haemorrhages and recurrent haemorrhages were also analysed. Results Optic disc haemorrhage was associated with systemic hypertension (odds ratio, 1.998; 95% confidence interval, 1.094-3.651; P ¼ 0.001). IOP range (P ¼ 0.080), diabetes (P ¼ 0.056), and use of aspirin (P ¼ 0.079) also tended to be associated with optic disc haemorrhage. No risk factor was significantly different between the single haemorrhage group and the recurrent haemorrhage group. ConclusionOptic disc haemorrhage was associated with systemic hypertension in patients with NTG.

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Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma

Cited by 181 publications

References 31 publications

Patterns of progression of localized retinal nerve fibre layer defect on red-free fundus photographs in normal-tension glaucoma

Patterns of progression of localized retinal nerve fibre layer defect on red-free fundus photographs in normal-tension glaucoma

Risk factors for progression of normal‐tension glaucoma under β‐blocker monotherapy

Risk factors associated with optic disc haemorrhage in patients with normal tension glaucoma

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