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K. Nitta, Y. Mawatari, T. Tanahashi, S. Ohkubo, T. Higashide, K. Sugiyama; Is the Enlargement Rate of Retinal Nerve Fiber Layer Defects or the Progression Rate of Visual Field Loss Associated With Disc Hemorrhage Occurence in Normal-Tension Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3341.
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To investigate the enlargement rate of retinal nerve fiber layer defects (RNFLD) and the progression rate of visual field loss in normal-tension glaucoma (NTG) patients with or without disc hemorrhage (DH).
Seventy-nine NTG patients diagnosed at Fukui-ken Saiseikai Hospital and followed up for at least 3 years at 1- to 2-month intervals by the same examiner were included in this study.We retrospectively reviewed the charts on 79 eyes of the 79 NTG patients (mean follow-up = 6.3 years). We examined the angle of RNFLD using fundus photographs (including black-white photographs) and the frequency of DH, and divided the patients into three groups: non-DH cases, single DH cases, and recurrent DH cases. We compared enlargement of RNFLD (ΔRNFLD/year: enlargement rate of RNFLD per year) and the visual field loss progression (MD slope: rate of change in MD index per year).
DH was detected in 29 out of 79 (36.7%) eyes in the NTG patients. The incidence of single DH was 19 out of 79 (24.1%) cases, and recurrent DH was 10 out of 79 (12.7%) cases. In 50 of 79 (63.3%) cases, DH was not detected in the follow-up periods. The MD slopes for the non-DH, the single DH, and the recurrent DH groups was 0.01±0.39dB/y, -0.28±0.51dB/y, and -0.53±0.64dB/y, respectively, with statistically significant differences between the groups (P<0.05). In addition, the ΔRNFLD/year of the non-DH, the single DH, and the recurrent DH groups was 0.22±0.65°/y, 1.64±1.35°/y, and 3.14±2.23°/y, respectively, with statistically significant differences between the groups (P<0.05).
The deterioration rate of enlargement of RNFLD and visual field loss seems to be closely associated with the frequency of DH occurrence.
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