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HanSeok Park, Seong Hee Shim, Joon Mo Kim, Chungkwon Yoo, Jeong Hun Bae; Prevalence of disc hemorrhages and its risk factors in an urban South Korean population, Kangbuk Samsung Cohort Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4273.
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This study was performed to estimate the prevalence of disc hemorrhages (DHs) and evaluate its related risk factors in an urban South Korean population.
The study design was prospective cohort study from the Health Screening Center of Kangbuk Samsung Hospital. Subjects who underwent health screening from August 2012 to July 2013 were enrolled in this study and all subjects agreed to participate in the cohort study. All of the fundus photographs were reviewed by two ophthalmologic doctors (HSP and SHS) first and were confirmed by two glaucoma specialists and one retina specialist (JMK, JGY, JHB). In addition to fundus photographs, systemic examinations, sociodemographics and behavioral characteristics questionnaires were administered to each subjects. Eyes with disc hemorrhage were assigned according to whether or not accompanied by retinal nerve fiber layer (RNFL) defects. Disc hemorrhages were divided into four types according to the proximal location (lamina cribrosa, cup margin, disc rim, and peripapillary types) as well as the quadrant location (inferotemporal, superotemporal, inferonasal, and superonasal).
Fundus photographs were available for 328,054 eyes of 164,027/169,209 (96.94%) subjects with an age of 20+ years. The prevalence of disc hemorrhages was 226/164,027 (0.14%; 95% confidence interval (CI): 0.12-0.16) per subject and 233/328,054 (0.07%; 95% CI: 0.06-0.08) per eye. Logistic regression analyses indicated that disc hemorrhages were associated with coincident RNFL defects (p<0.001), older age (p=0.001). A significantly higher proportion (48.0%) of disc rim-type DH was found in the DH with RNFL defects than in the DH without RNFL defects group (23.4%; P <0.001). Eyes with disc rim-type DH were 5.4 times more likely to be accompanied by RNFL defects than were eyes with peripapillary-type DH (95 % CI: 2.74-10.64; P < 0.001).
The prevalence of DHs was 0.14% in South Korean aged 20+ years. With RNFL defects and older age were associated with higher prevalence of DHs. Disc rim-type DH was significantly more common in eyes with RNFL defects than without RNFL defects.
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