title: Structural glaucomatous progression before and after occurrence of an optic disc haemorrhage.
abstract: BACKGROUND
  An optic disc haemorrhage (DH) has been associated with subsequent structural glaucoma progression, but it is unknown if there is structural progression prior to a DH. We evaluated a cohort of patients to determine whether structural progression occurs before a DH, after a DH or is simply associated with a DH.
  
  
  METHODS
  Eyes meeting inclusion criteria were placed into two groups. Group 1 included eyes that each had a baseline photograph of the optic nerve and a photograph with a DH at follow-up. Group 2 included eyes that each had a photograph of the optic nerve with a DH at baseline and a photograph at follow-up. Flicker images were created and graded by two ophthalmologists for structural glaucomatous change. We compared the proportion of structural progressors between Groups 1 and 2. Patient characteristics were also compared between the two groups.
  
  
  RESULTS
  49 patients and 51 unique eyes were included. Groups 1 and 2 had 28 and 38 sets of photographs, respectively. The proportion of global progression in Groups 1 and 2 were 21.4% and 39.5%, respectively (p=0.12). No significant differences in any structural progression feature and patient characteristics (besides age at time of DH (p=0.04) between the two groups were found.
  
  
  CONCLUSIONS
  Patients show structural glaucomatous progression before and after the event of a disc haemorrhage without significant differences. This suggests that a DH is an ongoing structural progression in glaucoma and may not be a discrete event that leads to subsequent progression.
authors: Weill Cornell Medical College, New York, New York, USA.
authors: Esther
authors: E
authors: Chung
authors: Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA.
authors: Anna M
authors: AM
authors: Demetriades
authors: Department of Public Health, Weill Cornell Medical College, New York, New York, USA.
authors: Paul J
authors: PJ
authors: Christos
authors: Department of Ophthalmology, Weill Cornell Medical College, New York, New York, USA.
authors: Nathan M
authors: NM
authors: Radcliffe
mesh_terms: D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012166:Retinal Hemorrhage / Q000175:diagnosis*; D012189:Retrospective Studies
keywords: Glaucoma; Imaging; Optic Nerve