March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Risk Factors for Optic Disc Hemorrhage in the Low-pressure Glaucoma Treatment Study
Christopher C. Teng; Carlos G. De Moraes; Jeffrey M. Liebmann; David S. Greenfield; Stuart K. Gardiner; Robert Ritch; Theodore Krupin; LoGTS Investigators
Author Affiliations & Notes
  • Christopher C. Teng
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
    Ophthalmology, NYU School of Medicine, New York, New York
  • Carlos G. De Moraes
    Ophthalmology, NYU School of Medicine, New York, New York
  • Jeffrey M. Liebmann
    Ophthalmology, NYU School of Medicine, New York, New York
  • David S. Greenfield
    Ophthalmology, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida
  • Stuart K. Gardiner
    Discoveries In Sight Laboratories, Devers Eye Institute, Portland, Oregon
  • Robert Ritch
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • Theodore Krupin
    Ophthalmology, Northwestern University, Chicago, Illinois
  • LoGTS Investigators
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • Footnotes
    Commercial Relationships  Christopher C. Teng, None; Carlos G. De Moraes, None; Jeffrey M. Liebmann, Alcon, Inc. (C), Allergan, Inc. (C), Carl Zeiss Meditech, Inc. (C), Diopsys, Inc. (C), Merz, Inc. (C), Optovue, Inc. (C), Quark, Inc. (C), Topcon, Inc. (C); David S. Greenfield, Alcon, Inc. (C, R), Allergan, Inc. (C, R), Merz, Inc. (C), Pfizer, Inc. (C), SOLX, Inc. (C), Topcon, Inc. (C); Stuart K. Gardiner, None; Robert Ritch, Aeon Astron (C), Drais Pharmaceutical (C), iSonic (C), Medacorp (C), Merck (R), Ocular Instruments (P), Pfizer (R); Theodore Krupin, Allergan, Inc. (C)
  • Footnotes
    Support  Allergan, Irvine, CA; Chicago Center for Vision Research, Chicago, IL; Research to Prevent Blindness, NY, NY; Ralph and Sylvia Ablon Research Fund of the New York Glaucoma Research Institute, NY, NY.
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 261. doi:
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      Christopher C. Teng, Carlos G. De Moraes, Jeffrey M. Liebmann, David S. Greenfield, Stuart K. Gardiner, Robert Ritch, Theodore Krupin, LoGTS Investigators; Risk Factors for Optic Disc Hemorrhage in the Low-pressure Glaucoma Treatment Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):261.

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Abstract

Purpose: : To investigate risk factors associated with optic disc hemorrhage (DH) in the Low-pressure Glaucoma Treatment Study (LoGTS), a prospective trial designed to compare the effects of the alpha2-adrenergic agonist brimonidine tartrate 0.2% to the beta-adrenergic antagonist timolol maleate 0.5% on visual function in low-pressure glaucoma.

Methods: : LoGTS participants with ≥ 5 visual fields during the follow-up were included. Optic disc photographs were reviewed for the presence of DH by two glaucoma specialists and cases of disagreement were adjudicated after consensus. Ocular and systemic risk factors were analyzed using generalized estimated equations (GEE) with a three-level ordinal response (0 for no DH, 1 for 1 DH, and 2 for recurrent DHs). Ocular and systemic risk factors (eg: age, gender, blood pressure, and ocular perfusion pressure) were investigated. Follow-up time and number of disc photographs were entered in the regression models given their confounding effect. Variables with p<0.25 in the univariate analysis were included in an initial multivariate model, and single backwards elimination was then used to derive the final model (alpha-level=0.05).

Results: : 253 eyes of 127 subjects (mean age, 64.7±10.9 years; mean follow-up, 40.6±12 months) were analyzed. 9/69 (13%) patients in the timolol group had at least one DH versus 5/58 (8%) in the brimonidine group (P =0.57). In the univariate analysis, the only significant factor for DH was positive history of migraine (OR =4.52, P =0.03). Randomization to timolol had an OR =1.77 (P =0.33). In the multivariate analysis, independent risk factors were female sex (OR =3.48, P =0.01), positive history of migraine (OR =2.81, P <0.01), and lower mean systolic pressure during follow-up (OR =1.03, P =0.05).

Conclusions: : Despite a trend of more DHs detected in the timolol group, randomization to brimonidine rather than timolol did not affect the risk of DH in LoGTS. The fact that other variables remained significant predictors underscores the role of IOP-independent factors in the pathogenesis of DHs in patients with low-pressure glaucoma.

Clinical Trial: : http://www.clinicaltrials.gov NCT00317577

Keywords: clinical (human) or epidemiologic studies: risk factor assessment • optic disc 
© 2012, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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