Clinical characteristics and prognostic significance of disc hemorrhage in open-angle and angle-closure glaucoma.
OBJECTIVE
To analyze the clinical characteristics and prognostic significance of disc hemorrhage in primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and primary angle-closure glaucoma (PACG).


METHODS
Records of patients with POAG, NTG, or PACG and a history of disc hemorrhage were collected for this retrospective, observational cohort study.


RESULTS
Of 1134 patients with POAG, 513 with NTG and 770 with PACG, 63 (5.6%), 36 (7.0%), and 44 (5.7%), respectively, had disc hemorrhage over a mean of 9 years of follow-up. There were no significant differences in the laterality, episodes, duration of hemorrhage, and frequency of recurrent hemorrhage among the 3 types. The intraocular pressure and cup-to-disc ratio did not differ significantly between eyes with and fellow eyes without hemorrhage. There was a significant association between disc hemorrhage and visual field progression [odds ratio: 2.78 (P = 0.004), 3.75 (P = 0.040), and 4.50 (P = 0.011) for POAG, NTG, and PACG, respectively].


CONCLUSIONS
Normal tension glaucoma has the highest incidence of disc hemorrhage, followed by PACG and POAG, which have similar incidence. The clinical characteristics of hemorrhage are not different among 3 types of glaucoma. The presence of disc hemorrhage is associated with the progression of glaucomatous optic neuropathy and visual field defects in POAG, NTG, and PACG.
Departments of Ophthalmology, Mackay Memorial Hospital, National Taiwan University, Taipei, Taiwan. yu_wen_66@yahoo.com
Jui-Wen
JW
Hsieh
Yu-Wen
YW
Lan
I-Jong
IJ
Wang
Fang-Ju
FJ
Sun
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000503:physiopathology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D057066:Low Tension Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D011379:Prognosis; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity; D058609:Visual Field Tests