title: Structural Differences in the Optic Nerve Head of Glaucoma Patients With and Without Disc Hemorrhages.
abstract: OBJECTIVE
  The aim of the study was to evaluate differences in planimetry, optic nerve parameters, and visual field (VF) indices in glaucomatous eyes with a disc hemorrhage (DH), their contralateral counterparts without DH, and normal controls.
  
  
  METHODS
  We retrospectively reviewed the records (from 1995 to 2013) of 44 glaucoma subjects with unilateral DH and 50 normal controls. In the DH group, 33 had bilateral fundus photos for planimetric analysis (Cyoptique GL), 15 had spectral domain-optical coherence tomography (SD-OCT), 15 had VF indices (Humphrey Visual Field Analyser), and 39 had ≥ 5 perimetry outputs for progression analysis (Progressor).
  
  
  RESULTS
  Structurally, planimetric analysis revealed that the eye with DH had a larger cup-disc ratio, more significantly in the vertical aspect (P<0.001), and a thinner rim (P=0.010), compared with the contralateral eye without DH. SD-OCT analysis also showed a thinner rim area (P<0.001), most significantly in 2, 3, and 9 clock hours and the inferior and superior quadrants (P<0.001) compared with the contralateral eye without DH and normal controls. Also, the vertical cup-disc ratio was larger (P<0.001). Functionally, VF deterioration was demonstrated by VF indices in eyes with DH-mean deviation: -10.69 versus -0.97, P<0.001 and pattern standard deviation: 6.60 versus 1.59, P<0.001, compared with normal controls.
  
  
  CONCLUSIONS
  Eyes with DH consistently displayed both structural features of more advanced glaucoma confirmed simultaneously on planimetry and SD-OCT, with concurrent VF deterioration.
authors.affiliation: *Singapore Eye Research Institute, Singapore National Eye Center †Department of Ophthalmology, Yong Loo Lin School of Medicine ‡Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: You Chuen
authors.initials: YC
authors.lastname: Chin
authors.forename: Shamira A
authors.initials: SA
authors.lastname: Perera
authors.forename: Tin A
authors.initials: TA
authors.lastname: Tun
authors.forename: Gillian H
authors.initials: GH
authors.lastname: Teh
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Mani
authors.initials: M
authors.lastname: Baskaran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005654:Fundus Oculi; D015812:Glaucoma, Angle-Closure / Q000503:physiopathology*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D012166:Retinal Hemorrhage / Q000503:physiopathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology