Optic disc hemorrhages detected in a large-scale eye disease screening project

To investigate the prevalence and characteristics of optic disc hemorrhages.

We took IMAGEnet fundus photographs of 14,779 participants, aged 40 years or older in a large-scale eye disease screening project conducted in Tajimi, Japan. A single researcher reviewed all of the photographs for the presence of ocular abnormality in the optic nerve head and retina, paying special attention to the presence or absence of optic disc hemorrhages. Glaucomatous optic neuropathy was diagnosed based on the presence of nerve fiber layer defects and/or the appearance of the optic disc.

Fundus photographs of 13,965 cases (27,930 eyes) were successfully reviewed bilaterally. We found disc hemorrhages at 92 locations of 92 (0.3%) eyes of 88 (0.6%) cases. Twenty-four hemorrhages of 23 (26%) cases were found in bilateral non-glaucoma cases and the remaining 68 hemorrhages of 65 (74%) cases were found in glaucoma cases. The prevalence of disc hemorrhages was 8.2% in 793 glaucoma cases and 0.2% in non-glaucoma cases. Hemorrhages developed significantly more frequently in females and in the elderly. The hemorrhages were predominantly found in the inferotemporal and superotemporal regions. The intraocular pressure was less than 20 mm Hg in all cases. The mean intraocular pressure was 15.0 mm Hg for glaucoma cases with hemorrhages and 13.9 mm Hg for non-glaucoma cases with hemorrhages.

Disc hemorrhages occur more frequently in females, in elderly persons, and in glaucoma cases in Japanese aged 40 or older. The intraocular pressure of the eyes with disc hemorrhages is close to that of the normal population.