title: Deterioration of visual fields in patients with glaucoma with and without optic disc hemorrhages.
abstract: OBJECTIVE
  To evaluate visual field deterioration in patients with glaucoma with and without optic disc hemorrhages (DHs).
  
  
  METHODS
  A prospective study at quarterly base involving annual perimetry; mean follow-up of 9 years.
  
  
  METHODS
  Outpatient department, nonreferral basis.
  
  
  METHODS
  Sixty-eight patients with primary open-angle glaucoma, 34 with normal pressure glaucoma (NPG), and 125 with ocular hypertension.
  
  
  RESULTS
  Visual field deterioration occurred in 32%, 32%, and 6% of the patients without DHs who had NPG, primary open-angle glaucoma, or ocular hypertension, respectively, while visual field deterioration occurred in 80%, 89%, and 14% of patients with DH, respectively. Cox proportional hazards ratio(CHR) for deterioration in patients with vs patients without DHs was 5.4 for NPG (P<.01) and 3.6 for primary open-angle glaucoma (P<.01). In patients with NPG and DHs, ipsilateral eyes with DHs deteriorated in 58%, while contralateral eyes without DHs deteriorated in 11% (CHR, 8.9; P<.04). For primary open-angle glaucoma and ocular hypertension, progression did not differ between eyes with DHs and contralateral eyes without DHs. Mean (+/-SD) interval between DHs and ipsilateral visual field deterioration was 3.1+/-1.7 years. No difference in the proportion of eyes progressing after single or recurrent DHs was noted. The position of DHs was related to the site of the visual field loss in 44% of the eyes.
  
  
  CONCLUSIONS
  The presence of DHs increased the risk of visual field deterioration. Disc hemorrhages were indicative only of deterioration in ipsilateral eyes in patients with NPG.
authors.affiliation: Department of Experimental Ophthalmology, The Netherlands Ophthalmic Research Institute, Amsterdam.
authors.forename: M T
authors.initials: MT
authors.lastname: Rasker
authors.forename: A
authors.initials: A
authors.lastname: van den Enden
authors.forename: D
authors.initials: D
authors.lastname: Bakker
authors.forename: P F
authors.initials: PF
authors.lastname: Hoyng
mesh_terms: D018450:Disease Progression; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007429:Intraocular Pressure; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D009898:Optic Disk / Q000098:blood supply*; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000150:complications / Q000503:physiopathology*; D014786:Vision Disorders / Q000503:physiopathology*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields / Q000502:physiology*