Comparison of Glaucoma Progression Between Unilateral and Bilateral Disc Hemorrhage Eyes and Associated Risk Factors for Progression

Abstract

Purpose: 

To compare glaucoma progression between unilateral and bilateral disc hemorrhage (DH) eyes and to determine the associated risk factors.

Methods: 

A total of 78 bilateral primary open-angle glaucoma (POAG) patients who had shown one or more occurrences of DH (48 eyes of 38 unilateral DH patients and 30 eyes of 30 bilateral DH patients) were included. Glaucoma progression was defined by visual field (VF) deterioration. The mean VF global indices progression rates in the pre-DH, post-DH and total follow-up periods were compared between the unilateral and bilateral DH groups. The cumulative probability of glaucoma progression between the 2 groups was compared by the Kaplan-Meier survival analysis. Univariate and multivariate Cox proportional hazard models were used to identify the risk factors for glaucoma progression.

Results: 

Among the mean VF global indices progression rates, only the mean pattern standard deviation progression rate showed a statistically significant difference between the groups (unilateral DH group: 0.30±0.38 dB/y; bilateral DH group: 0.13±0.27 dB/y) (P=0.042). The Kaplan-Meier analysis revealed a greater cumulative probability of progression in the unilateral than in the bilateral DH group (P=0.008). The multivariate Cox’s proportional hazard model indicated unilaterality of DH to be a factor associated with glaucoma progression (hazard ratio, 2.587; P=0.030).

Conclusions: 

In bilateral POAG patients with DH, unilaterality of DH is associated with glaucoma progression. Therefore, clinicians need to perform careful and frequent follow-up on bilateral POAG patients showing DH in only 1 eye during the follow-up period.