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I.G. Stalmans, T. Zeyen, S. Miglior, N. Pfeiffer, J. Cunha–Vaz, I. Adamsons, EGPS Study Group; Optic Disc Hemorrhages and Progression to Glaucoma in the European Glaucoma Prevention Study (EGPS) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3632.
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Purpose: To assess the sensitivity of fundoscopy and evaluation of optic disc stereo–photographs to detect optic disc hemorrhages (ODHs). To determine the predictive value of ODHs for the development of glaucoma. Methods: The European Glaucoma Prevention Study was designed to evaluate whether reducing the intra–ocular pressure in patients with ocular hypertension might reduce the risk of progression to glaucoma. All eyes included in the EGPS study were monitored for optic disc hemorrhages (ODHs) every 6 months for 5 years both by fundoscopy and evaluation of optic disc stereo–photographs. Chi–square test was used to compare the rates of progression. Results: 1342 eyes of 750 participants (drop–outs excluded) were analyzed. Thirty eyes (2,2%) developed ODHs on at least one occasion. Twenty–four ODHs (80%) were detected only on stereo–photos, 5 (16,7%) both by fundoscopy and evaluation of stereophotos, and 1 (3,3%) only by fundoscopy. The total percentage of eyes that developed glaucoma was 7,9% (106 out of 1342 eyes). Amongst the 30 eyes with ODHs, 7 (23,3%) developed glaucoma (p<0.01). Of the 6 patients with ODHs discovered on fundoscopy, 4 (66,7%) developed glaucoma. Conclusions: These results indicate that reading stereophotos may be more sensitive than fundoscopic examination at detecting ODHs. Disc hemorrhages are associated with an increased risk of progression to glaucoma, particularly when detected during fundoscopy.
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