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I. Bykhovskaya, S. Azen, M. Torres, R. Varma; Optic Disc Hemorrhage in Latinos: The Los Angeles Latino Eye Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5451.
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To determine the prevalence and associations of optic disc hemorrhage (DH) in a population-based sample of adult Latinos.
Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California, underwent a complete ophthalmologic examination, including measurement of intraocular pressure (IOP), visual field (VF) testing using an automated field analyzer, and simultaneous stereoscopic fundus photography of the optic disc. Out of these, 5756 people had gradable optic disc photographs. Ocular hypertension was defined as IOP of >21 mmHg and the absence of glaucomatous optic nerve damage (GOND). Open-angle glaucoma was defined as the presence of an open angle and a combination of glaucomatous VF abnormality and/or glaucomatous optic disc damage in at least one eye. DH was defined as a flame shaped or splinter-shaped hemorrhage that was radially oriented in the optic disc and went from the optic disc across the optic disc margin to the adjacent peripapillary retina. Presence of DH was ascertained by independent review of photographs by two clinicians and confirmed by a third reviewer.
DH was present in at least one eye of 20 persons, a prevalence of 0.35% (20/5756). The prevalence was higher in older persons compared to those who were younger. The prevalence of DH in OAG was 5.8% (17/291). No DH was noted in persons with ocular hypertension. The distribution of DH around the optic disc in persons with OAG included 59% in the inferior quadrant, 29% in the superior quadrant, 12% in the temporal quadrant. Of 8 persons who had neural rim notching, 6 had a disc hemorrhage within 2 clock hours of the notching site. The sensitivity of DH for GOND was 6% and the specificity was 85%.
The prevalence of DH in Latinos is low even though Latinos have a high prevalence of systemic diseases that have are associated with microvascular damage. The significantly higher prevalence of DH in persons with OAG highlights the specificity of this sign in persons with GOND. However, the poor sensitivity of DH limits its use as a screening measure for GOND.
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