Recurrent Optic Disc Hemorrhage and Its Association with Visual Field Deterioration in Glaucoma.

PURPOSE

To investigate the association among optic disc hemorrhage (ODH) recurrence, location, and visual field (VF) progression.

DESIGN

Prospective, observational study.

PARTICIPANTS

Patients with bilateral glaucoma or unilateral glaucoma with a fellow glaucoma suspect eye were enrolled.

METHODS

Patients received optic disc photography every 3 months and VF testing every 4 months. The disc was partitioned into 8 sectors to match 8 visual field (VF) sectors. The frequency of ODH in each sector was quantified over an average of 64 months. Global VF progression rate was calculated using linear regression on mean deviation. Sectoral progression rate was calculated using linear regression on the sensitivity at each VF location over time and then selecting the largest and second largest significant (P 8 ODH had faster VF progression than all other groups (all P < 0.001).

CONCLUSIONS

High-frequency ODH within optic disc sectors, equivalent to detecting ODH in 45% of 3 monthly eye examination visits, was associated with significantly worse VF progression than sectors with moderate or only 1 observed ODH. In addition, ODH occurring in different sectors in the same eye was more strongly associated with greater global VF progression compared with those occurring within the same sector.