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Abstract #84619 Published in IGR 21-1
Positive predictive value of optic disc haemorrhages for open angle glaucoma
Hogan B; Trew C; Annoh R; Yi Loo C; Ling Tan H; Shan Tang L; Tatham AJEye 2020; 34: 2029-2035
See also comment(s) by Gábor Holló •
OBJECTIVES: To determine the positive predictive value (PPV) of disc haemorrhages (DHs) for the diagnosis of open angle glaucoma (OAG). METHODS: A retrospective review of 618 consecutive new referrals by community optometrists to a hospital glaucoma service, including 54 patients with DHs. All patients had a comprehensive eye examination. The primary outcome was whether the patient was diagnosed with OAG in either eye, with a secondary outcome of whether they were discharged at the first visit (first visit discharge rate, FVDR). RESULTS: 54 of 618 patients (8.7%) had a DH noted at the time of referral, including 21 referred with DH alone. 29 patients with DHs were diagnosed with OAG for a PPV of 54% (95% CI 40-67%), falling to 24% (95% CI 8-47%) in those with DH alone. The overall FVDR was 35%, increasing to 57% in those referred due to DH alone. The FVDR for those referred with DH alone was significantly higher than the FDVR of 25% among the 564 patients referred with suspected glaucoma without a DH (P = 0.001). The FVDR decreased to 35% for patients with a DH plus one other feature of glaucoma and to 0% for patients with a DH and at least two other features suggestive of glaucoma. CONCLUSIONS: Almost 60% of patients referred due to isolated DHs were discharged at the first visit to the glaucoma clinic, however almost one in four was diagnosed with OAG. Patients with DH and other features suggestive of glaucoma had a higher probability of glaucoma diagnosis.
Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, 45 Chalmers Street, Edinburgh, EH3 9HA, UK.
Full articleClassification:
9.4.10 Glaucomas associated with hemorrhage (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
13.1 Prognostic factors (Part of: 13 Therapeutic prognosis and outcome)