Recurrent optic disc hemorrhage and its association with visual field deterioration in glaucoma

Abstract Objective To investigate the association between optic disc hemorrhage (ODH) recurrence, location and visual field (VF) progression. Design Prospective observational study. Participants Patients with bilateral glaucoma, or unilateral glaucoma with a fellow glaucoma suspect eye were enrolled. Methods Patients had optic disc photography every 3 months and standard automated perimetry every 4 months. The disc was partitioned into 8 sectors to match 8 visual field (VF) sectors. The total frequency of ODH in each sector was quantified over an average of 64 months. Global VF progression rate was calculated using linear regression on mean deviation. Sectoral progression rate was calculated using linear regression on the sensitivity at each VF location over time, then selecting the largest and second largest significant (P Main Outcome Measures Global and sectoral VF progression, ODH frequency, ODH recurrence (globally and sectoral) and its association with VF progression rate. Results 151 eyes from 77 patients completed the study with mean follow up of 64 months, 20 disc photos and 16 VF tests. With global VF analysis, eyes with ODH in 2 different sectors of the disc had worse progression rate than eyes with ODH in 1 sector (P=0.011) and eyes with no ODH (P 9 ODH had faster VF progression than all other groups (all P Conclusions High frequency ODH within optic disc sectors, equivalent to detecting ODH in 45% of 3 monthly eye examination visits was associated with significantly worse VF progression than sectors with moderate or only 1 observed ODH. In addition, ODH occurring in different sectors in the same eye were more strongly associated with greater global VF progression compared to those occurring within the same sector.