Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study

Area of Science:

• Ophthalmology
• Glaucomatology
• Neuroscience

Background:

• Disc hemorrhage is a clinical sign in glaucoma, particularly in low-tension glaucoma.
• Identifying risk factors for disc hemorrhage is crucial for predicting glaucoma progression.

Purpose of the Study:

• To investigate ocular and systemic risk factors associated with the detection of disc hemorrhage in the Low-Pressure Glaucoma Treatment Study.
• To determine if treatment randomization influenced disc hemorrhage occurrence or recurrence.

Main Methods:

• Analysis of a cohort from a randomized, double-masked, multicenter clinical trial (Low-Pressure Glaucoma Treatment Study).
• Inclusion of patients with at least 16 months of follow-up, excluding those with high intraocular pressure (IOP) or severe visual field loss.
• Stereophotographs were reviewed for disc hemorrhages, and Cox proportional hazards models were used to analyze risk factors.

Main Results:

• Migraine history (HR, 5.737), narrower baseline neuroretinal rim width (HR, 2.91), systemic beta-blocker use (HR, 5.585), low mean systolic blood pressure (HR, 1.06), and low mean arterial ocular perfusion pressure (HR, 1.172) were significant independent risk factors for disc hemorrhage detection.
• Treatment randomization to timolol or brimonidine did not affect the occurrence or recurrence of disc hemorrhages.

Conclusions:

• Migraine, narrower neuroretinal rim, low blood pressure, low ocular perfusion pressure, and systemic beta-blocker use are identified as significant risk factors for disc hemorrhage in low-pressure glaucoma.
• The study did not find an association between treatment randomization and the frequency of disc hemorrhage detection.