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Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma
K Ishida1, T Yamamoto, K Sugiyama
1Department of Ophthalmology, Gifu University School of Medicine, Gifu-shi, Japan.
American Journal of Ophthalmology
|August 6, 2000
Summary
Disk hemorrhage is a significant negative prognostic factor in normal-tension glaucoma, indicating progressive retinal nerve fiber layer damage and visual field loss. This finding highlights factors beyond intraocular pressure influencing disease progression.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Normal-tension glaucoma (NTG) is a chronic optic neuropathy characterized by visual field defects.
- Intraocular pressure is not the sole determinant of NTG progression.
Purpose of the Study:
- To investigate the association between disk hemorrhage in NTG and visual field defect progression.
- To determine if disk hemorrhage contributes to the pathogenesis of NTG.
Main Methods:
- Retrospective chart review of 70 NTG patients (mean follow-up 5.6 years).
- Cox proportional hazards model regression analysis to assess clinical factors influencing visual field progression.
- Two definitions of visual field progression: mean deviation change and glaucoma change probability analysis.
Main Results:
- Disk hemorrhage, corrected-pattern standard deviation, age, systolic blood pressure, and pulse rate significantly influenced visual field defects.
- Patients with disk hemorrhage showed significantly greater visual field loss progression (P ≤.0008).
- Recurrent disk hemorrhages were strongly associated with progression (P <.0001), with location correlating to visual field loss.
Conclusions:
- Disk hemorrhage is a significant negative prognostic factor in NTG.
- Disk hemorrhage may indicate progressive retinal nerve fiber layer damage.
- Factors other than intraocular pressure are crucial in NTG progression.