Optic disc hemorrhage in Asian glaucoma patients

G. Gazzzard, G. Gazzard, William Morgan, J. Devereux, P. Foster, F. Oen, S. Seah, P.T. Khaw, P. Chew

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17 Citations (Scopus)

Abstract

Purpose: To assess the prevalence of optic disc hemorrhage in Asian patients with established glaucoma using a recently described, highly sensitive detection method.Materials and Methods: Patients entering a trial of glaucoma filtering surgery in Southeast Asia (The Singapore 5FU Study) were assessed for the presence or absence of optic disc hemorrhage using stereo flicker chronoscopy of stereophotograph pairs.Results: A total of 167 patients (117 males and 50 females) were assessed, of whom 128 were Chinese. Primary open-angle glaucoma was diagnosed in 90 patients, primary angle-closure glaucoma in 69 patients, and pseudoexfoliative or pigment dispersion glaucoma in 7 patients. Five eyes of 5 patients had disc hemorrhage at enrollment (5/167), a rate of 2.99%. Four patients with disc hemorrhage had primary open-angle glaucoma and 1 had primary angle-closure glaucoma. There were no significant differences in global visual field indices, AGIS scores, or intraocular pressures between eyes with and without disc hemorrhage. All disc hemorrhages were seen in eyes prior to trabeculectomy.Conclusions: The prevalence of disc hemorrhage in the current study was comparable to that seen in primary open-angle glaucoma in clinic-based studies of white patients, but far less than that reported in normal-tension glaucoma studies. Hemorrhages were more common in primary open-angle glaucoma than primary angle-closure glaucoma.Bjerrum first described optic disc hemorrhage (DH) in association with glaucoma in 1889. 1 Since then small linear or flame-shaped hemorrhages at the optic disc have been shown to be an important prognostic sign associated with the progression of glaucomatous damage, frequently preceding both nerve fiber layer damage and visual loss. 2-11 Longitudinal data suggest that DH may be an early indicator of optic nerve pathology. 12-16 The reported prevalence of DH varies widely among diagnoses and studies, but is highest in normal-tension glaucoma (2.9-42%) and lowest in the normal population (0-0.7%). 2,10,14,17-22 It has been estimated that one third to three quarters of glaucoma patients may develop DH. 12,22 Most previous studies have concentrated on white or Japanese populations with primary open-angle glaucoma (POAG); no study to date has looked at Chinese patients, and only 1 report has discussed patients with primary angle-closure glaucoma (PACG). The aim of this study was to establish the prevalence of DH in Singaporean patients with glaucoma. A well-characterized group of Asian patients with medically uncontrolled glaucoma was examined assessed for the presence of DH using a proven, highly sensitive detection method, stereoflicker chronoscopy. 23-25
Original languageEnglish
Pages (from-to)226-231
JournalJournal of Glaucoma
Volume12
Issue number3
DOIs
Publication statusPublished - 2003

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