Clinical Significance of Optic Disc Hemorrhage Size in Visual Field Progression in Glaucoma

Abstract

Purpose

To investigate the correlation between optic disc hemorrhage (DH) size and glaucoma progression.

Design

A retrospective observational cohort study

Methods

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Setting

A single tertiary hospital in South Korea

Study Population

Two hundred and fifty (250) open-angle glaucoma (OAG) patients with DH. Participants were followed for 5 years or longer, with a minimum of 5 visual field (VF) tests.

Observation Procedure

The DH area was calculated by comparing the pixel numbers of the DH area with the disc area based on optical coherence tomography (OCT). For recurrent DH cases, we calculated the average DH area. DH size was classified as large or small based on the median value. Rates of mean deviation (MD) loss were determined using Guided Progression Analysis (GPA). Univariable and multivariable regression analyses were performed to identify significant predictors of MD loss.

Main outcome measures

DH size and longitudinal VF progression

Results

The mean follow-up period was 11.1 ± 3.6 years. The group with large DH showed faster global MD loss relative to the group with small DH (-0.51±0.48 dB/y vs. -0.36±0.42 dB/y, p = 0.01). In the multivariable model, mean DH size, maximum DH size, and initial MD were all significantly associated with the overall rate of MD loss (all p < 0.05).

Conclusions

DH size was associated with the rate of VF deterioration. Eyes with larger DH showed more pronounced VF progression.