AI Insight
This study examined 92 glaucoma patients who developed optic disc hemorrhages and identified factors predicting visual field deterioration over at least 3 years of follow-up. Four independent risk factors were associated with progressive vision loss: recurrent disc hemorrhages, longer eyeball length, thinner corneal thickness, and greater fluctuations in eye pressure. Among patients, 34.8% showed visual field progression while 65.2% remained stable during the study period.
Why it matters
These findings help ophthalmologists identify glaucoma patients at highest risk for vision loss after detecting disc hemorrhages, enabling more intensive monitoring and treatment adjustments. The identified risk factors are measurable clinical parameters that can guide personalized patient management and potentially prevent irreversible vision loss.
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by Haewon Lee, Ji Eun Song, Seong Ho Kim, Byeong Seok Kim, Yongwoo Lee
Background
To investigate the structural and clinical factors linked to visual field (VF) progression in glaucomatous eyes after the initial detection of optic disc haemorrhage (DH) in patients with primary open-angle glaucoma (POAG).
Methods
This study included 92 eyes of 92 patients who presented with at least one optic DH on stereoscopic optic disc and red-free photography. The included patients had a minimum follow-up of 3 years after initial detection of DH and at least 5 reliable standard automated perimetry investigations. VF progression was assessed using event-based guided progression analysis (GPA). Baseline demographic, clinical, and ocular parameters were examined using Cox proportional hazards regression to identify the independent predictors of functional deterioration.
Results
Among the patients, 32 (34.8%) showed VF progression and 60 (65.2%) remained stable. In univariate analysis, recurrent DH, longer axial length, thinner central corneal thickness (CCT), and intraocular pressure (IOP) fluctuation were significantly associated with VF progression. In multivariate analysis, recurrent DH (HR 4.008, p < 0.001), longer axial length (HR 1.287, p = 0.005), thinner CCT (HR 0.865, p = 0.005), and greater IOP fluctuation (HR 1.997, p = 0.032) remained independently associated with VF progression.
Conclusions
Recurrent DH, longer axial length, thinner CCT, and greater IOP fluctuation were independently associated with VF progression following optic DH. These factors may help identify glaucomatous eyes at higher risk of progression and support closer clinical monitoring after the initial detection of DH.