Optic disc hemorrhages in glaucoma and ocular hypertension: implications and recommendations.

PURPOSE OF REVIEW: To describe the epidemiology of disc hemorrhages and underscore the importance of detecting these markers of potential glaucomatous damage and progression. RECENT
FINDINGS: The Ocular Hypertension Treatment Study has confirmed that disc hemorrhages are an independent risk factor in the development of glaucoma. The risk of developing glaucoma was six times more likely in ocular hypertensive patients with disc hemorrhages compared with ocular hypertensive patients without disc hemorrhages. This study also highlighted the difficulty in detecting disc hemorrhages on clinical examination, noting that only 16% of disc hemorrhages detected on stereophotographs were identified on funduscopic examination. One study has demonstrated that surgical lowering of intraocular pressure decreased the occurrence of disc hemorrhages.
SUMMARY: Although the mechanism for the development of disc hemorrhages remains vague, the recent literature describes the difficulty in detecting disc hemorrhages, the importance of identifying this negative prognostic indicator and the effectiveness of intraocular pressure lowering with trabeculectomy in decreasing the risk of future disc hemorrhages.