advertisement
Abstract #96081 Published in IGR 22-3
Clinical Profiles of Glaucomatous Patients with High- and Low-tension Optic Disc Hemorrhages: A Comparative Study
Almeida INF; Dias DT; Alhadeff PA; Lopes FSS; Paranhos A; Ritch R; Gracitelli CPB; Prata TSJournal of Glaucoma 2022; 31: 178-182
PRCIS: Patients with low-tension optic disc hemorrhages are more frequently women, have NTG diagnosis and greater visual field loss. Symptoms of vascular dysregulation and Asian race also seem to be more prevalent in this clinical subtype. PURPOSE: Optic disc hemorrhage (DH) is an important glaucoma risk factor, and occurs in a wide intraocular pressure (IOP) range. We sought to characterize distinct clinical subtypes of patients with high- (HTDH) and low-tension DHs (LTDH). PATIENTS AND METHODS: In this cross-sectional study, treated glaucomatous patients with DHs from two Glaucoma Services were consecutively enrolled. Disc photographs were evaluated for the presence of DH by two glaucoma specialists. After inclusion, patients were classified on HTDH (IOP≥16▒mmHg) and LTDH (IOP<16▒mmHg; median split). Clinical and ocular data from the time of DH detection were compared between groups. RESULTS: One hundred thirty-three DH patients were included (LTDH=66 eyes; HTDH=67 eyes). Patients with LTDH were more often women than those with HTDH (77% vs. 42%; P=0.030). There was also a trend for a higher prevalence of Asian descendants (24% vs. 9%; P=0.058) and symptoms suggestive of vascular dysregulation (34% vs. 14%; P=0.057) in LTDH patients. Eyes with LTDH also had worse visual field (VF) mean deviation index (P=0.037), higher prevalence of normal-tension glaucoma (NTG) diagnosis (46% vs. 17%; P<0.001) and tended to have thinner central corneas (P=0.066). CONCLUSION: Patients developing DHs with treated IOPs in the low teens seem to more frequently fit in a profile represented by women, NTG diagnosis and greater VF loss. The presence of symptoms suggestive of vascular dysregulation and race also seem to differ between these two clinical subtypes. A closer optic disc surveillance is recommended for patients with the LTDH subtype, as they may develop DHs despite seemingly well-controlled IOP.
Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo - SP, Brazil Glaucoma Unit, Hospital Medicina dos Olhos, Osasco - SP, Brazil Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida.
Full article