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Disc hemorrhage most strongly associated with normal tension glaucoma
J Glaucoma. 2010;19(7):483-487.
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Disc hemorrhage proved most prominent in normal tension glaucoma and had similar anatomic qualities in normal tension glaucoma, primary angle-closure glaucoma and primary open-angle glaucoma, a study showed.
"As the presence of hemorrhage may influence surveillance and treatment, careful examination of the optic disc for this tiny but meaningful finding is essential in all patients with primary glaucoma, regardless of type," the study authors said.
The retrospective, observational cohort study included 1,134 patients with primary open-angle glaucoma, 513 patients with normal tension glaucoma and 770 patients with primary angle-closure glaucoma. The mean follow-up interval was 9 years.
Investigators identified disc hemorrhage in 5.6% of patients with primary open-angle glaucoma, 7% of eyes with normal tension glaucoma and 5.7% of eyes with primary angle-closure glaucoma. Hemorrhages had similar laterality, episodes, duration and frequency of recurrence in all three glaucoma types.
Data showed statistically significant relationships between disc hemorrhage and visual field progression in primary open-angle glaucoma (P = .004), normal tension glaucoma (P = .04) and primary angle-closure glaucoma (P = .011).
The authors theorized that disc hemorrhage is a sign of underlying vascular pathology, not structural changes in the optic nerve head attributable to high IOP.
"Our finding of no significant difference in the IOP of eyes with and fellow eyes without hemorrhage tends to support this hypothesis," the authors said.