Abstract #61718 Published in IGR 17-1

Structural Differences in the Optic Nerve Head of Glaucoma Patients With and Without Disc Hemorrhages

Chin YC; Perera SA; Tun TA; Teh GH; Cheung CY; Aung T; Wong TY; Baskaran M
Journal of Glaucoma 2016; 25: e76-e81

PURPOSE: 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. PATIENTS AND 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.

*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.

Full article


2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests) Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
9.4.10 Glaucomas associated with hemorrhage (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)

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