Tadamichi Akagi1, Luke J Saunders2, Takuhei Shoji3, Carlos Gustavo De Moraes4, Alon Skaat5, Patricia Isabel C Manalastas2, Christopher A Girkin6, Jeffrey M Liebmann4, Linda M Zangwill2, Robert N Weinreb7. 1. Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, California; Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. 2. Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, California. 3. Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, California; Department of Ophthalmology, Saitama Medical University, Saitama, Japan. 4. Department of Ophthalmology, Columbia University Medical Center, New York, New York. 5. Department of Ophthalmology, Columbia University Medical Center, New York, New York; Department of Ophthalmology, Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 6. Department of Ophthalmology, University of Alabama, Birmingham, Alabama. 7. Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, California. Electronic address: rweinreb@ucsd.edu.
Abstract
PURPOSE: To investigate the relationship between previous disc hemorrhage (DH) and subsequent rates of retinal nerve fiber layer (RNFL) thinning. DESIGN: Longitudinal, observational cohort study. PARTICIPANTS: Twenty-eight patients with glaucoma and patients with suspected glaucoma who had a history of DH in 1 eye (unilateral DH), but not in the fellow eye, enrolled in the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study were included. METHODS: All subjects underwent annual optic disc photography and semiannual spectral-domain OCT RNFL thickness measurements. Multivariable linear mixed-effects models were used to investigate the relationship between the presence of previous DH and RNFL thinning rates while adjusting for potential confounding factors, such as race, age, mean intraocular pressure (IOP), baseline disease severity, and central corneal thickness (CCT). The relationship between the timing of DH and the rates of RNFL thinning also was investigated in eyes with a history of DH. MAIN OUTCOME MEASURES: Rates of global and local RNFL thinning. RESULTS: Previous DH was significantly associated with faster RNFL thinning rates globally (-0.39 μm/year faster, P = 0.010), in DH quadrants (-0.77 μm/year faster, P = 0.012), and non-DH quadrants (-0.49 μm/year faster, P = 0.038) after adjustment for race, mean IOP, baseline age, baseline standard automated perimetry mean deviation, and CCT. Higher IOP was also significantly associated with faster thinning rates globally (-0.07 μm/year faster per 1 mmHg higher, P = 0.047) and in DH quadrants (-0.10 μm/year faster per 1 mmHg higher, P = 0.044). In eyes with a history of DH, the time elapsed from the latest DH episode to the first OCT examination was not significantly associated with the rate of RNFL thinning. CONCLUSIONS: A history of DH is an independent risk factor for faster rates of RNFL thinning in non-DH quadrants and in DH quadrants; this risk is present even in eyes that exhibited DH several years earlier.
PURPOSE: To investigate the relationship between previous disc hemorrhage (DH) and subsequent rates of retinal nerve fiber layer (RNFL) thinning. DESIGN: Longitudinal, observational cohort study. PARTICIPANTS: Twenty-eight patients with glaucoma and patients with suspected glaucoma who had a history of DH in 1 eye (unilateral DH), but not in the fellow eye, enrolled in the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study were included. METHODS: All subjects underwent annual optic disc photography and semiannual spectral-domain OCT RNFL thickness measurements. Multivariable linear mixed-effects models were used to investigate the relationship between the presence of previous DH and RNFL thinning rates while adjusting for potential confounding factors, such as race, age, mean intraocular pressure (IOP), baseline disease severity, and central corneal thickness (CCT). The relationship between the timing of DH and the rates of RNFL thinning also was investigated in eyes with a history of DH. MAIN OUTCOME MEASURES: Rates of global and local RNFL thinning. RESULTS: Previous DH was significantly associated with faster RNFL thinning rates globally (-0.39 μm/year faster, P = 0.010), in DH quadrants (-0.77 μm/year faster, P = 0.012), and non-DH quadrants (-0.49 μm/year faster, P = 0.038) after adjustment for race, mean IOP, baseline age, baseline standard automated perimetry mean deviation, and CCT. Higher IOP was also significantly associated with faster thinning rates globally (-0.07 μm/year faster per 1 mmHg higher, P = 0.047) and in DH quadrants (-0.10 μm/year faster per 1 mmHg higher, P = 0.044). In eyes with a history of DH, the time elapsed from the latest DH episode to the first OCT examination was not significantly associated with the rate of RNFL thinning. CONCLUSIONS: A history of DH is an independent risk factor for faster rates of RNFL thinning in non-DH quadrants and in DH quadrants; this risk is present even in eyes that exhibited DH several years earlier.
Authors: Ou Tan; Liang Liu; Qisheng You; Jie Wang; Aiyin Chen; Eliesa Ing; John C Morrison; Yali Jia; David Huang Journal: Transl Vis Sci Technol Date: 2021-05-03 Impact factor: 3.283