Structural and functional differences in Glaucoma Patients with Disc Haemorrhage

Abstract

Purpose: To evaluate differences in planimetry, optic nerve parameters and visual field indices; in glaucomatous eyes with a disc haemorrhage (DH), their contralateral counterparts without DH, and normal controls.

Methods: We retrospectively reviewed the records of 44 glaucoma subjects with unilateral DH and 50 normal controls. In the DH group, 33 had bilateral fundus photos for planimetric analysis (CyoptiqueTM GL), 15 had SD-OCT, 15 had visual field indices (Humphrey Visual Field Analyzer) and 39 had ≥5 perimetry outputs for progression analysis (ProgressorTM).

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. 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, vertical cup-disc ratio was larger (P<0.001). Functionally, visual field deterioration was demonstrated by visual field indices in eyes with DH - mean deviation: -10.69 vs -0.97, P<0.001 and pattern standard deviation: 6.60 vs 1.59, P<0.001.

Conclusions: Eyes with DH consistently displayed structural features of more advanced glaucoma confirmed on planimetry and SD-OCT, with visual field deterioration.

Keywords: 758 visual fields • 627 optic disc