Topographic characteristics of optic disc hemorrhage in primary open-angle glaucoma

To investigate the topographic characteristics of optic disc hemorrhage (DH) and the factors associated with DH area in POAG.

We enrolled 128 POAG eyes (with DH) of 128 patients consecutively. Digital red-free retinal nerve fiber layer (RNFL) photographs and digital color stereo disc photographs of the enrolled eyes were reviewed, and the DH locations were measured. The DH area was calculated based on RNFL deviation map/RNFL photographs overlay image.

Disc hemorrhages were most common in the inferotemporal inferior sector (58.0%) and the disc rim (40.6%) in terms of octant and proximal location, respectively. In a multivariate analysis, a larger DH area was associated with older age (P < 0.01), use of acetylsalicylic acid (P = 0.03), lower cup-to-disc ratio (P < 0.01), and lower baseline IOP (P = 0.01). In normal-baseline IOP-POAG eyes (n = 88), the overall DH area and length of maximum radial extent of DH were larger than in high-baseline IOP-POAG eyes (n = 40) (P = 0.04 and 0.03, respectively).

In POAG eyes, DH was larger in area and longer in length in cases of normal-baseline IOP than in cases of high-baseline IOP. This suggests the possibility that previous studies' findings of higher DH prevalence and incidence in normal-baseline IOP-POAG eyes were partially affected by these topographic characteristics, which make DH more easily detectable.