Abstract
Purpose::
Optic disc hemorrhage (DH) is one of the most important risk factors for progression of glaucoma. DH is reportedly observed more frequently in normal-tension glaucoma (NTG) than in primary open angle glaucoma, and prevalence of NTG is as high as 3.6% in Japan.1 We investigated prevalence of DH and its relating systemic and ocular factors in participants of the Tajimi Study, a population-based glaucoma survey in Japan.1
Methods::
3021 out of eligible residents (78.1%) underwent the screening examinations including non-mydriatic fundus photographs. All fundus photographs were reviewed by one experienced examiner (IA) to determine the presence of DH. To decide factors associating with DH other than glaucoma in non-glaucoma subjects, the relating factors were studied using logistic analysis with stepwise selection in which the independent variable was the presence of DH and the dependent ones were sex, age, mean blood pressure, height, weight, refractive error, intraocular pressure, central corneal thickness, optic disc area, presence of parapapillary atrophy (PPA) -alpha, and area of PPA-beta. A DH-positive eye in each subject with DH and a randomly chosen eye in each subject without DH were analyzed.
Results::
Fundus photographs with sufficient quality were available in 2911 subjects. DH was found in at least one eye in 36 subjects (prevalence = 1.2%, 95% confidence interval 0.9 - 1.6%), including 19 of 145 subjects with definitive glaucoma (prevalence 13.1%), 7 of 74 with glaucoma suspect (9.5%), and 10 of 2692 non-glaucoma subjects (0.4%). Prevalence of DH was significantly different among the 3 groups (P<0.001, chi-square test). The logistic analysis revealed that higher age (P<0.001) and larger area of PPA-beta (P=0.040) were significantly associated with the presence of DH in non-glaucoma subjects.
Conclusions::
Prevalence of DH in a Japanese population aged 40 or older in Tajimi was 1.2%. DH was found approximately 30 times more frequently in subjects with definitive glaucoma than in non-glaucoma subjects. Other than glaucoma, higher age and greater area of PPA-beta were significantly associated with DH.1, Iwase et al. Ophthalmology 2004;111:1641-1648
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment • optic disc