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S. M. Fernando, C. G. V. De Moraes, C. C. Teng, C. Tello, R. Ritch, J. M. Liebmann; Exfoliation Syndrome, Intraocular Pressure and Disc Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2681.
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To assess the relationship of unilateral disc hemorrhage (DH) and ocular parameters in subjects with bilateral exfoliation syndrome (XFS).
The medical records and disc photographs of all patients seen in a glaucoma referral practice between January 1999 and October 2009 were reviewed by two glaucoma specialists. Age, ethnicity, presence or absence of XFS, CCT, visual field MD, intraocular pressure (IOP), and location of the DH were recorded.
We identified 40 subjects with unilateral DH and bilateral XFS. Mean age was 75.4±8.9 yrs, 27 (66%) were female, and 39 (98%) were of European descent. The majority of DH (25 eyes, 63%) occurred inferotemporally. There was no significant difference in spherical equivalent refractive error (-0.77±2.40 vs. -0.97±2.59 diopters, p=0.4), visual field mean deviation (-8.84±8.9 vs. -8.48±7.5 dB, p=0.6), or CCT (535.2±36.9 and 536.4±40.2 µm, p=0.7) in eyes with or without DH. Mean IOP prior to DH (17.2±3.7 vs. 15.9±3.7, p=0.004) and IOP at the time of DH detection (17.16±4.25 vs.15.08±5.08 mmHg, p=0.001) were higher in the DH eyes. There was a 45% (p=0.8) correlation between the DH eye and the eye with the worse visual field MD, 55% (p=0.9) between the location of the DH with the worse visual field hemifield, 43% (p=0.6) between the DH eye and the eye with worse XFS, and 65% (p=0.07) between the DH eye and the larger disc size. 72% (p=0.0003) of DH eyes had larger beta-zone parapapillary atrophy (PPA).
In bilateral XFS, DH tended to occur in the eye with the higher IOP and the larger PPA. No other ocular parameters were identified that were associated with the occurrence of DH in bilateral XFS.
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