title: Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study.
abstract: OBJECTIVE
  To investigate risk factors for disc hemorrhage detection in the Low-Pressure Glaucoma Treatment Study.
  
  
  METHODS
  Cohort of a randomized, double-masked, multicenter clinical trial.
  
  
  METHODS
  Low-Pressure Glaucoma Treatment Study patients with at least 16 months of follow-up were included. Exclusion criteria included untreated intraocular pressure (IOP) of more than 21 mm Hg, visual field mean deviation worse than -16 dB, or contraindications to study medications. Patients were randomized to topical treatment with timolol 0.5% or brimonidine 0.2%. Stereophotographs were reviewed independently by 2 masked graders searching for disc hemorrhages. The main outcomes investigated were the detection of disc hemorrhage at any time during follow-up and their recurrence. Ocular and systemic risk factors for disc hemorrhage detection were analyzed using the Cox proportional hazards model and were tested further for independence in a multivariate model.
  
  
  RESULTS
  Two hundred fifty-three eyes of 127 subjects (mean age, 64.7 ± 10.9 years; women, 58%; European ancestry, 71%) followed up for an average ± standard deviation of 40.6 ± 12 months were included. In the multivariate analysis, history of migraine (hazard ratio [HR], 5.737; P = .012), narrower neuroretinal rim width at baseline (HR, 2.91; P = .048), use of systemic β-blockers (HR, 5.585; P = .036), low mean systolic blood pressure (HR, 1.06; P = .02), and low mean arterial ocular perfusion pressure during follow-up (HR, 1.172; P = .007) were significant and independent risk factors for disc hemorrhage detection. Treatment randomization was not associated with either the occurrence or recurrence of disc hemorrhages.
  
  
  CONCLUSIONS
  In this cohort of Low-Pressure Glaucoma Treatment Study patients, migraine, baseline narrower neuroretinal rim width, low systolic blood pressure and mean arterial ocular perfusion pressure, and use of systemic β-blockers were risk factors for disc hemorrhage detection. Randomization assignment did not influence the frequency of disc hemorrhage detection.
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York.
authors: Rafael L
authors: RL
authors: Furlanetto
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York. Electronic address: demoraesmd@gmail.com.
authors: Carlos Gustavo
authors: CG
authors: De Moraes
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York.
authors: Christopher C
authors: CC
authors: Teng
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York.
authors: Jeffrey M
authors: JM
authors: Liebmann
authors: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida.
authors: David S
authors: DS
authors: Greenfield
authors: Devers Eye Institute, Legacy Health, Portland, Oregon.
authors: Stuart K
authors: SK
authors: Gardiner
authors: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York Medical College, Valhalla, New York.
authors: Robert
authors: R
authors: Ritch
authors: Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; The Chicago Center for Vision Research, Chicago, Illinois.
authors: Theodore
authors: T
authors: Krupin
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D000068438:Brimonidine Tartrate; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D057066:Low Tension Glaucoma / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000503:physiopathology*; D016016:Proportional Hazards Models; D011810:Quinoxalines / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D013999:Timolol / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D013999:Timolol