Dataset Information

Impact of optic disc hemorrhage on subsequent glaucoma progression in mild-to-moderate myopia.

ABSTRACT: To investigate optic disc hemorrhage (DH)'s clinical implications to subsequent progression of primary open-angle glaucoma (POAG) in cases of mild-to-moderate myopia.Retrospective comparative study.(1) Fifty-nine (59) myopic (26.5 mm > axial length [AXL] ? 24.0 mm) POAG patients with DH and (2) 59 age-, AXL-, and mean deviation (MD) of visual field (VF)-matched controls without DH were evaluated over the course of a minimum 3.5 years of follow up. For clear assessment of the effect of DH on progression of glaucoma, the patients selected for inclusion in the study were those with stable IOP (i.e., those showing an at least 20% reduction relative to the baseline IOP) whose IOP-lowering medication was not increased, supplemented or changed during the follow-up period.The patients' optic disc/retinal nerve fiber layer (RNFL) photographs were independently evaluated by three glaucoma specialists for structural progression of glaucoma. Event-based analysis with Guided Progression Analysis (GPA) software was used to determine their functional progression. The durations of structural and functional progression were compared by Kaplan-Meier life survival analyses.Optic disc/RNFL progression and VF progression.The mean follow-up periods between the DH and non-DH groups were not significantly different: in the DH group, 5.6±2.7 years; in the non-DH group, 5.4±2.6 years (P = 0.588). In the DH group, 30 (50.8%) of 59 eyes manifested optic disc/RNFL deterioration; in the non-DH group, however, only 17 (28.8%) of 59 eyes showed structural progression. For the DH group, the cumulative probability of structural glaucoma progression was significantly greater than for the non-DH group (P = 0.001; log rank test). Interestingly, the two groups did not significantly differ in the cumulative probability of functional progression (P = 0.79; log rank test): in the DH group, VF progression was observed in 14 eyes (23.7%); in the non-DH group, in 12 eyes (20.3%).DH was associated with a greater probability of structural progression in medically well-controlled-IOP POAG eyes with mild-to-moderate myopia. However, the relevance of DH to VF progression was not clear over the course of the average 5.5-year duration of the study.

SUBMITTER: Ha A

PROVIDER: S-EPMC5734762 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Impact of optic disc hemorrhage on subsequent glaucoma progression in mild-to-moderate myopia.

Ha Ahnul A Kim Young Kook YK Jeoung Jin Wook JW Park Ki Ho KH

PloS one 20171218 12

<h4>Purpose</h4>To investigate optic disc hemorrhage (DH)'s clinical implications to subsequent progression of primary open-angle glaucoma (POAG) in cases of mild-to-moderate myopia.<h4>Design</h4>Retrospective comparative study.<h4>Participants</h4>(1) Fifty-nine (59) myopic (26.5 mm > axial length [AXL] ≥ 24.0 mm) POAG patients with DH and (2) 59 age-, AXL-, and mean deviation (MD) of visual field (VF)-matched controls without DH were evaluated over the course of a minimum 3.5 years of follow ...[more]

PMID: 29253013

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Project description:PurposeTo investigate whether lamina cribrosa (LC) defects are associated with optic disc morphology in primary open angle glaucoma (POAG) eyes with high myopia.MethodsA total of 129 POAG patients and 55 age-matched control subjects with high myopia were evaluated. Three-dimensional scan images obtained by swept source optical coherence tomography were used to detect LC defects. Radial B-scans and infrared images obtained by spectral domain optical coherence tomography were used to measure ?-peripapillary atrophy (PPA) lengths with and without Bruch's membrane (BM) (temporal, nasal, superior, and inferior), tilt angle (vertical and horizontal), and disc diameter (transverse and longitudinal). Peripapillary intrachoroidal cavitations (PICCs), disc area, ovality index, and cyclotorsion of the optic disc were analyzed as well.ResultsLC defects were found in 70 of 129 (54.2%) POAG eyes and 1 of 55 (1.8%) control eyes (P < 0.001). Age, sex, spherical equivalent, axial length, intraocular pressure, and central corneal thickness were not significantly different among POAG eyes with LC defects, POAG eyes without LC defects, and control eyes. Temporal PPA lengths without BM in all three groups correlated significantly with vertical and horizontal tilt angles, although no PPA length with BM correlated significantly with any tilt angle. PICCs were detected more frequently in POAG eyes with LC defects than those without LC defects (P = 0.01) and control eyes (P = 0.02). POAG eyes with LC defects showed a smaller ovality index (P = 0.004), longer temporal PPA without BM (P < 0.001), and larger vertical/horizontal tilt angles (vertical, P < 0.001; horizontal, P = 0.01), and transverse diameter (P = 0.01). In multivariate analysis for the presence of LC defects, presence of POAG (P < 0.001) and vertical tilt angle (P < 0.001) were identified as significant.ConclusionsThe presence of LC defects was associated with myopic optic disc morphology in POAG eyes with high myopia.

Project description:PurposeTo investigate the differences in the frequency of optic disc hemorrhage (DH) and prevalence of beta-zone parapapillary atrophy (βPPA) between individuals of African descent (AD) and European descent (ED).DesignProspective, multicenter, observational cohort.ParticipantsA total of 1950 eyes of 1172 participants of the African Descent and Glaucoma Evaluation Study (ADAGES).MethodsStereoscopic disc photographs of subjects with and without glaucomatous optic neuropathy (GON) followed during the first 13 years of the ADAGES underwent masked review searching for DH and βPPA. A total of 928 eyes (non-GON, 581; GON, 347) of 551 AD patients (non-GON, 334; GON, 217) and 1022 eyes (non-GON, 568; GON, 454) of 611 ED patients (non-GON, 334; GON, 277) were included. We compared the number of eyes with detected DH at any time during follow-up and eyes with βPPA between the AD and ED groups. The analyses were then adjusted for clinical parameters using multivariable logistic regression.Main outcome measuresDifferences in frequency of DH and prevalence of βPPA.ResultsA total of 9395 stereoscopic disc photographs were reviewed. More ED eyes experience DH than AD eyes (49/1022 [4.8%] vs. 10/928 eyes [1.1%], respectively; P < 0.001), whereas βPPA had higher prevalence in AD eyes (675 eyes [72%] vs. 659 eyes [64%]; P < 0.001). In the final multivariable model, after controlling for confounders, AD eyes were less likely to have at least 1 detected DH than ED eyes (odds ratio [OR], 0.21; 95% CI, 0.10-0.45; P < 0.001) but were more likely to have βPPA than ED eyes (OR, 1.55; 95% CI, 1.12-2.14; P = 0.008).ConclusionsSubjects of ED are at higher risk for developing DH compared with AD subjects, whereas AD subjects have greater prevalence of βPPA. These findings suggest that there are structural differences within the optic nerve complex between these groups. Further research is needed to determine whether racial differences in the frequency of DH and prevalence of βPPA affect the likelihood of glaucomatous progression.

Project description:PurposeThe influence of myopia on glaucoma progression remains unknown, possibly because of the multifactorial nature of glaucoma and difficulty in assessing a solo contribution of myopia. The purpose of this study is to investigate the association of myopia with visual field (VF) progression in glaucoma using a paired-eye design to minimize the influence of confounding systemic factors that are diverse among individuals.MethodsThis retrospective study evaluated 144 eyes of 72 subjects with open-angle glaucoma, with similar intra-ocular pressure between paired eyes, spherical equivalent (SE) ≤ -2 diopter (D), and axial length ≥ 24 mm. Paired eyes with faster and slower VF progression were grouped separately, according to the global VF progression rate assessed by automated pointwise linear regression analysis. The SE, axial length, tilt ratio and torsion angle of optic discs, Bruch's membrane (BM) opening area, and gamma zone parapapillary atrophy (PPA) width were compared between the two groups. Factors associated with faster VF progression were determined by logistic regression analysis.ResultsThe mean follow-up duration was 8.9 ± 4.4 years. The mean value of SE and axial length were -6.31 ± 1.88 D and 26.05 ± 1.12 mm, respectively. The mean global visual field progression rate was -0.32 ± 0.38 dB/y. Tilt ratio, BM opening area, and gamma zone PPA width were significantly greater in the eyes with faster VF progression than those with slower progression. In multivariate analysis, these factors were significantly associated with faster VF progression (all P < 0.05), while SE and axial length were not associated with it.ConclusionIn myopic glaucoma subjects, tilt of the optic disc and temporal shifting and enlargement of the BM opening were associated with faster rate of VF progression between paired eyes. This suggests that myopia influences VF progression in glaucomatous eyes via optic disc deformations rather than via refractive error itself.

Dataset Information

Impact of optic disc hemorrhage on subsequent glaucoma progression in mild-to-moderate myopia.

Publications

Impact of optic disc hemorrhage on subsequent glaucoma progression in mild-to-moderate myopia.

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