PURPOSE: Parapapillary atrophy (PPA) and disc hemorrhage (DH) are associated with glaucoma. We sought to determine whether they are anatomically related. DESIGN: Retrospective study. METHODS: All digital optic nerve stereophotographs obtained over a one-year period were screened for the presence of DH. Only patients with DH were included. The location of the greatest beta zone PPA width as defined by the radial distance between the scleral rim and the outer border of the beta zone was compared in each patient. The clock hour location of the DH was determined. Baseline central corneal thickness, intraocular pressure, vertical cup-to-disc ratio, and visual field indices were obtained. RESULTS: Photographs from 1,559 glaucoma patients were evaluated and 46 eyes with unilateral DH were identified; 42 (91.3%) had beta zone PPA and 38 eyes had asymmetric PPA width. DH occurred more frequently in the eye with the greater PPA width (29/38 eyes [76.3%]; kappa = 0.611; P < .001). The DH fell on the point of greatest PPA width in 10 (23.9%) of 42 eyes (P < .05, Fisher exact test) and within two clock hours of the greatest PPA width in 31 (73.8%) of 42 eyes (P < .001, Chi-square test). Logistic regression analysis determined that greater PPA width (odds ratio, 17.16; 95% confidence interval, 5.34 to 55.12; P < .001) was the only ocular characteristic to predict the laterality of the DH. CONCLUSIONS: DHs tend to occur in the eye with the greatest PPA width and usually are found within the region of its greatest width.
PURPOSE:Parapapillary atrophy (PPA) and disc hemorrhage (DH) are associated with glaucoma. We sought to determine whether they are anatomically related. DESIGN: Retrospective study. METHODS: All digital optic nerve stereophotographs obtained over a one-year period were screened for the presence of DH. Only patients with DH were included. The location of the greatest beta zone PPA width as defined by the radial distance between the scleral rim and the outer border of the beta zone was compared in each patient. The clock hour location of the DH was determined. Baseline central corneal thickness, intraocular pressure, vertical cup-to-disc ratio, and visual field indices were obtained. RESULTS: Photographs from 1,559 glaucomapatients were evaluated and 46 eyes with unilateral DH were identified; 42 (91.3%) had beta zone PPA and 38 eyes had asymmetric PPA width. DH occurred more frequently in the eye with the greater PPA width (29/38 eyes [76.3%]; kappa = 0.611; P < .001). The DH fell on the point of greatest PPA width in 10 (23.9%) of 42 eyes (P < .05, Fisher exact test) and within two clock hours of the greatest PPA width in 31 (73.8%) of 42 eyes (P < .001, Chi-square test). Logistic regression analysis determined that greater PPA width (odds ratio, 17.16; 95% confidence interval, 5.34 to 55.12; P < .001) was the only ocular characteristic to predict the laterality of the DH. CONCLUSIONS: DHs tend to occur in the eye with the greatest PPA width and usually are found within the region of its greatest width.
Authors: Kaweh Mansouri; Jonathan D Tung; Felipe A Medeiros; Ali Tafreshi; Syril Dorairaj; Linda Zangwill; Feng He; Sonia Jain; Robert N Weinreb Journal: Acta Ophthalmol Date: 2013-03-18 Impact factor: 3.761
Authors: Alon Skaat; Carlos Gustavo De Moraes; Christopher Bowd; Pamela A Sample; Christopher A Girkin; Felipe A Medeiros; Robert Ritch; Robert N Weinreb; Linda M Zangwill; Jeffrey M Liebmann Journal: Ophthalmology Date: 2016-04-23 Impact factor: 12.079
Authors: Carolina P B Gracitelli; Andrew J Tatham; Linda M Zangwill; Robert N Weinreb; Ting Liu; Felipe A Medeiros Journal: PLoS One Date: 2014-08-26 Impact factor: 3.240