September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
African Descent and Glaucoma Evaluation Study (ADAGES): The association between optic disc hemorrhages and central visual field defects
Author Affiliations & Notes
  • Portia Sirinek
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Dana Blumberg
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • C Gustavo De Moraes
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • George A Cioffi
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Christopher A Girkin
    School of Medicine, University of Alabama, Birmingham, Alabama, United States
  • Felipe A Medeiros
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Linda M Zangwill
    Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, San Diego, California, United States
  • Jeffrey M Liebmann
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Footnotes
    Commercial Relationships   Portia Sirinek, None; Dana Blumberg, None; C Gustavo De Moraes, National Eye Institute (F), Research to Prevent Blindness (F); George Cioffi, National Eye Institute (F), Research to Prevent Blindness (F); Christopher Girkin, Carl Zeiss Meditech, Inc. (F), EyeSight Foundation of Alabama (F), Heidelberg Engineering, GmbH (F), National Eye Institute (F), Research to Prevent Blindness (F), SOLX (F); Felipe Medeiros, Alcon (C), Allergan (F), Allergan (C), Ametek (F), Ametek (C), Bausch+Lomb (F), Carl-Zeiss Meditec (F), Carl-Zeiss Meditec (C), Carl Zeiss Meditec Inc (R), Heidelberg Engineering (F), Heidelberg Engineering (C), Sensimed (F), Topcon (F); Robert Weinreb, Alcon, Inc. (C), Allergan, Inc. (C), Bausch+Lomb (C), Carl Zeiss Meditec (F), Carl Zeiss Meditech, Inc. (C), Carl Zeiss Meditec Inc. (R), Genentech (F), Heidelberg Engineering (F), Optovue (F), Topcon (C), Topcon (F); Linda Zangwill, Carl Zeiss Meditec Inc. (F), Carl Zeiss Meditec Inc. (R), Heidelberg Engineering GmbH (F), Optovue Inc. (F), Optovue Inc. (R), Quark (F), Topcon Medical Systems Inc. (F); Jeffrey Liebmann, Alcon, Inc. (C), Allergan, Inc. (C), Bausch & Lomb, Inc. (F), Carl Zeiss Meditech, Inc. (F), Diopysis, inc. (F), Diopysis, inc. (C), Diopysis, inc. (E), Heidelberg Engineering, GmbH (F), Merz Phamaceuticals, Inc. (C), National Eye Institute (F), New York Glaucoma Research Institute (F), Optovue, inc (F), Quark Pharmaceuticals, Inc. (C), Reichert, Inc. (C), Reichert, Inc. (F), Sensimed, Inc. (C), SOLX, Inc. (F), Sustained Nano System (E), Topcon, Inc. (F), Valeant Pharmaceutiicals, Inc. (C)
  • Footnotes
    Support  P30EY022589 Eyesight Foundation of Alabama; Alcon Laboratories Inc.; Allergan Inc.; Pfizer Inc.; Merck Inc.; Santen Inc.; and the Edith C. Blum Research Fund of the New York Glaucoma Research Institute, New York, NY, Unrestricted grant from Research to Prevent Blindness, New York, New York; Shirlee and Bernard Brown Research Laboratory; Linda M Zangwill: EY11008, EY019869, P30 EY022589; Felipe A. Medieros: EY021818, EY025056; Christopher Bowd: EY022039; Robert N. Weinreb: EY023704, K12EY024225, Research to Prevent Blindness; C. Gustavo De Moraes: R01EY025253, Research to Prevent Blindness
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2600. doi:
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    • Get Citation

      Portia Sirinek, Dana Blumberg, C Gustavo De Moraes, George A Cioffi, Christopher A Girkin, Felipe A Medeiros, Robert N Weinreb, Linda M Zangwill, Jeffrey M Liebmann; African Descent and Glaucoma Evaluation Study (ADAGES): The association between optic disc hemorrhages and central visual field defects. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2600.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the relationship between presence and location of optic disc hemorrhages (DH) and central visual field defects (CVFD).

Methods : Design: Cross-sectional analysis. Participants: 784 eyes of 484 participants with glaucomatous optic neuropathy were included from the African Descent and Glaucoma Evaluation Study (ADAGES). Each participant underwent standard automated perimetry (24-2 SITA, Humphrey Field Analyzer II) and had stereoscopic disc photos taken annually for up to 13 years. Disc photos were reviewed for the presence and location of DH by two masked investigators. An eye was considered to have a significant CVFD if the pattern deviation of one of the four central-most points of the 24-2 fields had a P value < 1% on at least two dates. Other definitions of CVFD were also tested by modifying the number of abnormal points and their spatial relationships.

Results : DH occurred in 42 eyes, 37 in patients of European descent and 5 in patients of African descent. 27 patients had inferotemporal DH, while 15 had DH exclusively in other sectors. 14 eyes had recurrent DH, most of which were in the inferotemporal location. 250 eyes had a CVFD. In the multivariable analyses, DH was a significant and independent predictor of CVFD (OR=2.55, 95% CI 1.23-5.29, P=0.01), which was also true for inferotemporal DH alone (OR=4.62, 95% CI 1.83-11.62, P<0.01) as well as recurrent DH (OR=4.43, 95% CI 1.33-14.78, P=0.02). Other significant risk factors for CVFD included European descent (P=0.04), presence of beta-zone parapapillary atrophy (P<0.01), more severe baseline mean deviation (P<0.01), and lower mean follow-up intraocular pressure (P<0.01). Similar findings were confirmed using other definitions of CVFD.

Conclusions : DH, particularly if inferotemporal or recurrent, is associated with a CVFD. Identification of DH should prompt more intensive surveillance of the central visual field.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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