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.
Hsieh
Jui-Wen
JW
Departments of Ophthalmology, Mackay Memorial Hospital, National Taiwan University, Taipei, Taiwan. yu_wen_66@yahoo.com
Lan
Yu-Wen
YW
Wang
I-Jong
IJ
Sun
Fang-Ju
FJ
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