Rafael L Furlanetto1, Carlos Gustavo De Moraes2, Christopher C Teng3, Jeffrey M Liebmann3, David S Greenfield4, Stuart K Gardiner5, Robert Ritch6, Theodore Krupin7. 1. Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York. 2. Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York. Electronic address: demoraesmd@gmail.com. 3. Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York. 4. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Palm Beach Gardens, Florida. 5. Devers Eye Institute, Legacy Health, Portland, Oregon. 6. Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York; Department of Ophthalmology, New York Medical College, Valhalla, New York. 7. Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; The Chicago Center for Vision Research, Chicago, Illinois.
Abstract
PURPOSE: To investigate risk factors for disc hemorrhage detection in the Low-Pressure Glaucoma Treatment Study. DESIGN: Cohort of a randomized, double-masked, multicenter clinical trial. METHODS:Low-Pressure Glaucoma Treatment Study patients with at least 16 months of follow-up were included. Exclusion criteria included untreated intraocular pressure (IOP) of more than 21 mm Hg, visual field mean deviation worse than -16 dB, or contraindications to study medications. Patients were randomized to topical treatment with timolol 0.5% or brimonidine 0.2%. Stereophotographs were reviewed independently by 2 masked graders searching for disc hemorrhages. The main outcomes investigated were the detection of disc hemorrhage at any time during follow-up and their recurrence. Ocular and systemic risk factors for disc hemorrhage detection were analyzed using the Cox proportional hazards model and were tested further for independence in a multivariate model. RESULTS:Two hundred fifty-three eyes of 127 subjects (mean age, 64.7 ± 10.9 years; women, 58%; European ancestry, 71%) followed up for an average ± standard deviation of 40.6 ± 12 months were included. In the multivariate analysis, history of migraine (hazard ratio [HR], 5.737; P = .012), narrower neuroretinal rim width at baseline (HR, 2.91; P = .048), use of systemic β-blockers (HR, 5.585; P = .036), low mean systolic blood pressure (HR, 1.06; P = .02), and low mean arterial ocular perfusion pressure during follow-up (HR, 1.172; P = .007) were significant and independent risk factors for disc hemorrhage detection. Treatment randomization was not associated with either the occurrence or recurrence of disc hemorrhages. CONCLUSIONS: In this cohort of Low-Pressure Glaucoma Treatment Study patients, migraine, baseline narrower neuroretinal rim width, low systolic blood pressure and mean arterial ocular perfusion pressure, and use of systemic β-blockers were risk factors for disc hemorrhage detection. Randomization assignment did not influence the frequency of disc hemorrhage detection.
RCT Entities:
PURPOSE: To investigate risk factors for disc hemorrhage detection in the Low-Pressure Glaucoma Treatment Study. DESIGN: Cohort of a randomized, double-masked, multicenter clinical trial. METHODS:Low-Pressure Glaucoma Treatment Study patients with at least 16 months of follow-up were included. Exclusion criteria included untreated intraocular pressure (IOP) of more than 21 mm Hg, visual field mean deviation worse than -16 dB, or contraindications to study medications. Patients were randomized to topical treatment with timolol 0.5% or brimonidine 0.2%. Stereophotographs were reviewed independently by 2 masked graders searching for disc hemorrhages. The main outcomes investigated were the detection of disc hemorrhage at any time during follow-up and their recurrence. Ocular and systemic risk factors for disc hemorrhage detection were analyzed using the Cox proportional hazards model and were tested further for independence in a multivariate model. RESULTS: Two hundred fifty-three eyes of 127 subjects (mean age, 64.7 ± 10.9 years; women, 58%; European ancestry, 71%) followed up for an average ± standard deviation of 40.6 ± 12 months were included. In the multivariate analysis, history of migraine (hazard ratio [HR], 5.737; P = .012), narrower neuroretinal rim width at baseline (HR, 2.91; P = .048), use of systemic β-blockers (HR, 5.585; P = .036), low mean systolic blood pressure (HR, 1.06; P = .02), and low mean arterial ocular perfusion pressure during follow-up (HR, 1.172; P = .007) were significant and independent risk factors for disc hemorrhage detection. Treatment randomization was not associated with either the occurrence or recurrence of disc hemorrhages. CONCLUSIONS: In this cohort of Low-Pressure Glaucoma Treatment Study patients, migraine, baseline narrower neuroretinal rim width, low systolic blood pressure and mean arterial ocular perfusion pressure, and use of systemic β-blockers were risk factors for disc hemorrhage detection. Randomization assignment did not influence the frequency of disc hemorrhage detection.
Authors: Craig Wilde; Ali Poostchi; Rajesh Narendran; Hamish K MacNab; Jonathan G Hillman; Phillip Alexander; Winfried M Amoaku; Stephen A Vernon Journal: Eye (Lond) Date: 2018-11-01 Impact factor: 3.775
Authors: Alon Harris; Giovanna Guidoboni; Brent Siesky; Sunu Mathew; Alice C Verticchio Vercellin; Lucas Rowe; Julia Arciero Journal: Prog Retin Eye Res Date: 2020-01-24 Impact factor: 21.198