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Clinical characteristics of glaucoma patients with disc hemorrhage in different locations

  • Yun Hsia
  • Chien-Chia Su
  • Tsing-Hong Wang
  • Jehn-Yu HuangEmail author
Glaucoma

Abstract

Purpose

To compare the clinical characteristics and outcomes of eyes with unilateral disc hemorrhage (DH) in different locations.

Methods

This was a retrospective cohort study. DHs were classified by locations: the superior, superotemporal, inferotemporal, or inferior sectors of optic disc were classified as the susceptible area, while other sectors were defined as the less susceptible area. Structural and functional outcomes were analyzed by the Humphrey field analyzer and spectral domain optical coherence tomography.

Results

Forty-three eyes with DHs in the susceptible area were less myopic and had more peripapillary-type DH, larger cup-to-disc ratio, cup volume, and disc area. Thirty-three eyes with DHs in the less susceptible area had less association with RNFL defects, greater tilted ratio, and less torsion of the disc. Follow-up revealed that the change in sectoral RNFL (μm) thickness was significantly greater for DHs in the susceptible area within one year (− 6.0 ± 14.0 vs. 0.7 ± 13.0, p = 0.035) and two years (− 10.0 ± 17.4 vs. − 1.1 ± 7.6, p = 0.012), while the change in average RNFL thickness was not different. Eyes with DHs in the susceptible area had faster MD deterioration (dB/year) than those in the less susceptible area within four years (− 0.32 ± 0.51 vs. − 0.05 ± 0.45, p = 0.047). A total of 16.9% of eyes, all in the susceptible area, had localized VF progression at DH corresponding area.

Conclusion

Disc hemorrhage in the superotemporal and inferotemporal regions had more subsequent structural and functional deterioration compared with the eyes with DHs in the temporal quadrant and nasal area.

Keywords

Glaucoma Disc hemorrhage Visual field Retinal nerve fiber layer 

Notes

Acknowledgments

English editing and statistical consultation were provided by the department of medical research at National Taiwan University Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

No Informed consent was obtained from the participants included in the study. Informed consent was not mandatory for this retrospective study.

References

  1. 1.
    Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z (2007) Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology 114:1965–1972CrossRefGoogle Scholar
  2. 2.
    Suh MH, Park KH (2014) Pathogenesis and clinical implications of optic disk hemorrhage in glaucoma. Surv Ophthalmol 59:19–29CrossRefGoogle Scholar
  3. 3.
    Suh MH, Park KH, Kim H, Kim TW, Kim SW, Kim SY et al (2012) Glaucoma progression after the first-detected optic disc hemorrhage by optical coherence tomography. J Glaucoma 21:358–366CrossRefGoogle Scholar
  4. 4.
    Akagi T, Zangwill LM, Saunders LJ, Yarmohammadi A, Manalastas PIC, Suh MH et al (2017) Rates of local retinal nerve fiber layer thinning before and after disc hemorrhage in glaucoma. Ophthalmology 124:1403–1411Google Scholar
  5. 5.
    Kernstock C, Dietzsch J, Januschowski K, Schiefer U, Fischer MD (2012) Optical coherence tomography shows progressive local nerve fiber loss after disc hemorrhages in glaucoma patients. Graefes Arch Clin Exp Ophthalmol 250:583–587Google Scholar
  6. 6.
    Hwang YH, Kim YY, Kim HK, Sohn YH (2014) Changes in retinal nerve fiber layer thickness after optic disc hemorrhage in glaucomatous eyes. J Glaucoma 23:547–552Google Scholar
  7. 7.
    Siegner SW, Netland PA (1996) Optic disc hemorrhages and progression of glaucoma. Ophthalmology 103:1014–1024CrossRefGoogle Scholar
  8. 8.
    De Moraes CG, Prata TS, Liebmann CA, Tello C, Ritch R, Liebmann JM (2009) Spatially consistent, localized visual field loss before and after disc haemorrhage. Invest Ophthalmol Vis Sci 50:4727–4733CrossRefGoogle Scholar
  9. 9.
    Furlanetto RL, De Moraes CG, Teng CC, Liebmann JM, Greenfield DS, Gardiner SK et al (2014) Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study. Am J Ophthalmol 157:945–952CrossRefGoogle Scholar
  10. 10.
    Budenz DL, Anderson DR, Feuer WJ, Beiser JA, Schiffman J, Parrish RK 2nd et al (2006) Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study. Ophthalmology 113:2137–2143CrossRefGoogle Scholar
  11. 11.
    Tomidokoro A, Iwase A, Araie M, Yamamoto T, Kitazawa Y (2009) Population-based prevalence of optic disc haemorrhages in elderly Japanese. Eye 23:1032–1037CrossRefGoogle Scholar
  12. 12.
    Healey PR, Mitchell P, Smith W, Wang JJ (1998) Optic disc hemorrhages in a population with and without signs of glaucoma. Ophthalmology 105:216–223CrossRefGoogle Scholar
  13. 13.
    Yoo YC, Kim JM, Park HS, Yoo C, Shim SH, Won YS et al (2017) Specific location of disc hemorrhage is linked to nerve fiber layer defects. Optom Vis Sci 94:647–653CrossRefGoogle Scholar
  14. 14.
    Kim YK, Park KH, Yoo BW, Kim HC (2014) Topographic characteristics of optic disc hemorrhage in primary open-angle glaucoma. Invest Ophthalmol Vis Sci 55:169–176CrossRefGoogle Scholar
  15. 15.
    Sonnsjo B, Dokmo Y, Krakau T (2002) Disc haemorrhages, precursors of open angle glaucoma. Prog Retin Eye Res 21:35–56CrossRefGoogle Scholar
  16. 16.
    Ozturker ZK, Munro K, Gupta N (2017) Optic disc hemorrhages in glaucoma and common clinical features. Can J Ophthalmol 52:583–591CrossRefGoogle Scholar
  17. 17.
    Kotowski J, Wollstein G, Ishikawa H, Schuman JS (2014) Imaging of the optic nerve and retinal nerve fiber layer: an essential part of glaucoma diagnosis and monitoring. Surv Ophthalmol 59:458–467CrossRefGoogle Scholar
  18. 18.
    Hood DC (2017) Improving our understanding, and detection, of glaucomatous damage: an approach based upon optical coherence tomography (OCT). Prog Retin Eye Res 57:46–75CrossRefGoogle Scholar
  19. 19.
    Lee EJ, Han JC, Kee C (2017) A novel hypothesis for the pathogenesis of glaucomatous disc hemorrhage. Prog Retin Eye Res 60:20–43CrossRefGoogle Scholar
  20. 20.
    Schindelin J, Arganda-Carreras I, Frise E, Kaynig V, Longair M, Pietzsch T et al (2012) Fiji: an open-source platform for biological-image analysis. Nat Methods 9:676–682CrossRefGoogle Scholar
  21. 21.
    Park HY, Lee K, Park CK (2012) Optic disc torsion direction predicts the location of glaucomatous damage in normal-tension glaucoma patients with myopia. Ophthalmology 119:1844–1851CrossRefGoogle Scholar
  22. 22.
    Garway-Heath DF, Poinoosawmy D, Fitzke FW, Hitchings RA (2000) Mapping the visual field to the optic disc in normal tension glaucoma eyes. Ophthalmology 107:1809–1815CrossRefGoogle Scholar
  23. 23.
    Diehl DL, Quigley HA, Miller NR, Sommer A, Burney EN (1990) Prevalence and significance of optic disc hemorrhage in a longitudinal study of glaucoma. Arch Ophthal 108:545–550CrossRefGoogle Scholar
  24. 24.
    Yamamoto T, Iwase A, Kawase K, Sawada A, Ishida K (2004) Optic disc hemorrhages detected in a large-scale eye disease screening project. J Glaucoma 13:356–360CrossRefGoogle Scholar
  25. 25.
    Hood DC, Fortune B, Arthur SN, Xing D, Salant JA, Ritch R et al (2008) Blood vessel contributions to retinal nerve fiber layer thickness profiles measured with optical coherence tomography. J Glaucoma 17:519–528CrossRefGoogle Scholar
  26. 26.
    Prata TS, De Moraes CG, Teng CC, Tello C, Ritch R, Liebmann JM (2010) Factors affecting rates of visual field progression in glaucoma patients with optic disc hemorrhage. Ophthalmology 117:24–29CrossRefGoogle Scholar
  27. 27.
    Chung E, Demetriades AM, Christos PJ, Radcliffe NM (2015) Structural glaucomatous progression before and after occurrence of an optic disc haemorrhage. Br J Ophthalmol 99:21–25CrossRefGoogle Scholar
  28. 28.
    Sousa MC, Biteli LG, Dorairaj S, Maslin JS, Leite MT, Prata TS (2015) Suitability of the visual field index according to glaucoma severity. J Curr Glaucoma Pract 9:65–68CrossRefGoogle Scholar
  29. 29.
    Kimura Y, Hangai M, Morooka S, Takayama K, Nakano N, Nukada M et al (2012) Retinal nerve fiber layer defects in highly myopic eyes with early glaucoma. Invest Ophthalmol Vis Sci 53:6472–6478CrossRefGoogle Scholar
  30. 30.
    de Moraes CG, Liebmann JM, Medeiros FA, Weinreb RN (2016) Management of advanced glaucoma: characterization and monitoring. Surv Ophthalmol 61:597–615CrossRefGoogle Scholar
  31. 31.
    Jonas JB, Fernandez MC, Sturmer J (1993) Pattern of glaucomatous neuroretinal rim loss. Ophthalmology 100:63–68CrossRefGoogle Scholar
  32. 32.
    Chin YC, Perera SA, Tun TA, Teh GH, Cheung CY, Aung T et al (2016) Structural differences in the optic nerve head of glaucoma patients with and without disc hemorrhages. J Glaucoma 25:e76–e81CrossRefGoogle Scholar
  33. 33.
    Miki A, Ikuno Y, Asai T, Usui S, Nishida K (2015) Defects of the lamina cribrosa in high myopia and glaucoma. PLoS One 10:e0137909CrossRefGoogle Scholar
  34. 34.
    Lee JE, Sung KR, Lee JY, Park JM (2015) Implications of optic disc tilt in the progression of primary open-angle glaucoma. Invest Ophthalmol Vis Sci 56:6925–6931CrossRefGoogle Scholar
  35. 35.
    Han JC, Lee EJ, Kim SH, Kee C (2016) Visual field progression pattern associated with optic disc tilt morphology in myopic open-angle glaucoma. Am J Ophthalmol 169:33–45CrossRefGoogle Scholar
  36. 36.
    Berenberg TL, Metelitsina TI, Madow B, Dai Y, Ying GS, Dupont JC et al (2012) The association between drusen extent and foveolar choroidal blood flow in age-related macular degeneration. Retina 32:25–31CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyNational Taiwan University HospitalTaipeiTaiwan

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