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

Abstract

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.

Contributing Factors for Progression of Visual Field Loss in Normal-tension Glaucoma Patients With Medical Treatment

“…45,46 In prospective studies, 42,47 DH has been confirmed as an important prognostic factor for further disease progression, especially in NTG. 42,[48][49][50] In the present study, DH showed no correlation with VFD progression in any of the subfields. One possible explanation for this is that only subjects who could be followed up under topical medication for Z5 years were included in the study population, and eyes with evident progression of VF, where DH is more likely to be encountered, were excluded.…”

Clinical Significance of the Location of Recurrent Optic Disc Hemorrhage in Glaucoma

“…One study showed that use of aspirin and systemic hypertension were associated with DH in eyes with normaltension glaucoma. 23 In our study, the use of aspirin was significantly different between the nonrecurrent and recurrent DH groups. This difference was more pronounced between the recurrent DH group at the same location (21.4%) and different locations (50.0%), occurring at a higher rate in the latter.…”

Spontaneous Retinal Venous Pulsation and Disc Hemorrhage in Open-Angle Glaucoma

“…Patients in whose eyes DH has never been observed were included in the control group. We compared sex, age, diagnosis, associated systemic abnormalities (diabetes mellitus, systemic hypertension, migraine, tendency to cold hands) obtained through history taking 22 between the DH group and the control group.…”