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POSTERIOR FUNDUS HEMORRHAGES: Frequency and Associated Factors The Beijing Eye Study

Zhou, Jin Qiong, MD*; Wang, Ya Xing, MD; Xu, Liang, MD; Zhao, Liang, MD; Wang, Shuang, MD; Xu, Jie, MD; You, Qi Sheng, MD; Yang, Hua, MD; Wei, Wen Bin, MD*; Jonas, Jost B., MD

doi: 10.1097/IAE.0000000000002122
Original Study: PDF Only

Purpose: To examine frequency and associations of retinal hemorrhages.

Methods: The population-based Beijing Eye Study included 3,468 individuals. Monoscopic fundus photographs were examined for hemorrhages.

Results: Retinal hemorrhages were detected in 515 eyes (429 individuals) (prevalence: 7.6%; 95% confidence interval [CI]: 7.0–8.0 per eye; 12.7%; 95% CI: 11.7–13.7 per person). Higher prevalence of retinal hemorrhages was correlated (multivariate analysis) with higher systolic blood pressure (P < 0.001; odds ratio: 1.02; 95% CI: 1.01–1.03), higher prevalence of diabetic retinopathy (P < 0.001; odds ratio: 121; 95% CI: 61–240), and higher prevalence of retinal vein occlusions (P < 0.001; odds ratio: 27; 95% CI: 17–42). Retinal hemorrhages were due to diabetic retinopathy (189 [36.7%] eyes), retinal vein occlusions (n = 65 [12.6%]), posterior vitreous detachment (n = 23 [4.5%]), glaucoma (n = 14 [2.7%]), exudative age-related macular degeneration (n = 8 [1.6%]), hypertensive retinopathy (n = 10 [1.9%]), and exudative myopic maculopathy (n = 1 [0.2%]). Retinal hemorrhages without evident ocular cause (“NOH”) were detected in 204 (3.0%) eyes (or 39.6% of all retinal hemorrhages). Higher prevalence of NOHs was correlated with higher systolic blood pressure (P < 0.001; odds ratio: 1.02; 95% CI: 1.01–1.03) after adjusting for blood glucose concentration and prevalence of cortical cataract.

Conclusion: In a population-based recruited cohort of individuals aged 50+ years, prevalence of any fundus hemorrhage was about 8% per eye and 13% per individual. Approximately 60% of the hemorrhages were due to ocular reasons, mainly diabetic retinopathy, retinal vein occlusions, and posterior vitreous detachment, whereas 40% of the bleedings were not evidently associated with ophthalmologic causes but strongly with elevated systolic blood pressure.

In individuals aged 50+ years, prevalence of any fundus hemorrhage was 8% per eye and 13% per individual. Approximately 60% of hemorrhages were due to ocular reasons, mainly diabetic retinopathy, retinal vein occlusions, and posterior vitreous detachment, whereas 40% of the bleedings were strongly associated with elevated systolic blood pressure.

*Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China;

Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China; and

Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany.

Reprint requests: Prof. Wen Bin Wei, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Science Key Laboratory, 1 Dong Jiao Min Xiang, Dong Cheng District, Beijing, China 100730; e-mail: tr_weiwenbin@163.com

Supported by National Natural Science Foundation of China (Grant # 81770890).

Jin Qiong Zhou and Ya Xing Wang equally contributed to the study and share the first authorhip. J. B. Jonas—Consultant for Mundipharma Co, (Cambridge, United Kingdom); Patent holder with Biocompatibles UK Ltd (Franham, Surrey, United Kingdom) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or antiangiogenic factor; Patent number: 20120263794), and patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). The remaining authors have no conflicts of interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.