Longitudinal Association Between Disc Hemorrhage and Primary Open-Angle Glaucoma Progression: A Systematic Review and...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Medical Diagnostics

Background:

• Optic disc hemorrhages (DH) are key indicators in primary open-angle glaucoma (POAG).
• The impact of initial DH on POAG and normal tension glaucoma (NTG) progression lacks extensive longitudinal data.
• Understanding DH's role is crucial for predicting glaucoma worsening.

Purpose of the Study:

• To systematically review and meta-analyze the association between baseline DH and POAG/NTG progression.
• To determine if initial DH influences the rate of glaucoma worsening.
• To investigate the link between DH location and visual field deterioration.

Main Methods:

• Systematic review and meta-analysis of observational studies (PROSPERO CRD42021292572).
• Searched PubMed, Embase, Cochrane, SCOPUS, and Web of Science up to July 1, 2025.
• Included studies on patients aged 18+ with defined POAG/NTG progression criteria.

Main Results:

• 22 studies (7 prospective, 15 retrospective) were included.
• Baseline DH significantly associated with POAG progression (OR=4.51) and NTG progression (OR=5.15).
• DH commonly occurred inferotemporally, correlating with visual field defect locations.

Conclusions:

• Baseline DH is a significant predictor of POAG progression, particularly in NTG.
• Patients with POAG and baseline DH require intensified monitoring for retinal nerve fiber layer thinning and visual field loss.
• DH presence warrants closer clinical surveillance in glaucoma management.