Topographic optic disc changes in glaucoma patients following disc haemorrhages: A case–control study.

Abstract

Abstract: : Purpose: To determine whether glaucoma patients with optic disc haemorrhages (ODH) have a higher frequency of optic disc change than those without ODH. Methods: 26 eyes of 23 patients with open–angle glaucoma (median age, 70 years; range, 47 to 80 years), who are part of a cohort being followed in a prospective study, were identified as having ODH during follow–up. These eyes were matched to 26 control eyes from 25 patients (median age, 61 years; range, 43 to 79 years) who were never noted to have ODH and were followed in the same study. Matching was based on amount of rim loss corrected by disc size and visual field mean deviation. Optic disc change was determined in a consensus decision by 3 expert observers masked to the identity, visual field status and whether the eyes belonged to the ODH or control group, using the topographical change analysis program of the HRT software, which compares follow–up exams with a baseline exam and highlights superpixels with significant topographic change. The baseline image chosen was the one taken immediately before the detection of the optic disc haemorrhage (within 6 months). Survival analysis, using disc change as endpoint, was performed. Results: The mean + SD follow–up was 4.1 + 2.5 years for patients with ODH and 7.3 + 2.2 years for patients without ODH. The cumulative probability of topographic disc change was significantly greater for eyes with ODH (P = 0.002, log rank test; figure). After 5 years, 13 eyes (50%) with ODH and 9 eyes (35%) without ODH showed optic disc deterioration (P = 0.04). Conclusions: This study confirms that eyes with ODHs have a higher risk of optic disc progression.  

Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • optic disc