1
|
Almeida INF, Dias DT, Alhadeff PA, Lopes FSS, Paranhos A, Ritch R, Gracitelli CPB, Prata TS. Clinical Profiles of Glaucomatous Patients With High-tension and Low-tension Optic Disc Hemorrhages: A Comparative Study. J Glaucoma 2022; 31:178-182. [PMID: 34506356 DOI: 10.1097/ijg.0000000000001937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 08/24/2021] [Indexed: 11/26/2022]
Abstract
PRCIS Patients with low-tension optic disc hemorrhages (DHs) are more frequently women, have a diagnosis of normal-tension glaucoma (NTG) diagnosis and greater visual field (VF) loss. Symptoms of vascular dysregulation and Asian race also seem to be more prevalent in this clinical subtype. PURPOSE Optic 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-tension disc hemorrhage (HTDH) and low-tension disc hemorrhage (LTDH). PATIENTS AND METHODS In this cross-sectional study, treated glaucomatous patients with DHs from 2 glaucoma services were consecutively enrolled. Disc photographs were evaluated for the presence of DH by 2 glaucoma specialists. After inclusion, patients were classified on HTDH (IOP≥16 mm Hg) and LTDH (IOP<16 mm Hg; 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 VF mean deviation index (P=0.037), higher prevalence of NTG diagnosis (46% vs. 17%; P<0.001), and tended to have thinner central corneas (P=0.066). CONCLUSIONS 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 2 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.
Collapse
Affiliation(s)
| | - Diego T Dias
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, SP, Brazil
| | - Paula A Alhadeff
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
| | - Flavio S S Lopes
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo
| | - Augusto Paranhos
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
| | | | - Tiago S Prata
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, SP, Brazil
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL
| |
Collapse
|
2
|
David RCC, Moghimi S, Do JL, Hou H, Proudfoot J, Zangwill LM, Kamalipour A, Nishida T, De Moraes CG, Girkin CA, Liebmann JM, Weinreb RN. Characteristics of Central Visual Field Progression in Eyes with Optic Disc Hemorrhage. Am J Ophthalmol 2021; 231:109-119. [PMID: 34107310 DOI: 10.1016/j.ajo.2021.05.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the characteristics and rate of central visual field loss after optic disc hemorrhage (DH). DESIGN Prospective cohort study. METHODS Three hundred forty-three eyes of 220 subjects who had ≥3 years of follow-up with a minimum of 5 visits with 10-2 and 24-2 visual field (VF) were recruited. Rates of 10-2 mean deviation (MD) loss in each hemifield and predefined zones were compared using linear mixed-effects models in DH and non-DH eyes. Clustered pointwise regression analysis was also used to define central VF progressors and compared with 24-2 VF loss using guided progression analysis. RESULTS Thirty-nine eyes with DH and 304 eyes without DH had a mean follow-up of 5.2 years. Eyes with DH had rates of 10-2 MD loss that were 3 times faster than non-DH eyes (mean difference -0.36 dB/year [95% confidence interval 0.54-0.18]; P < .001) and were 3.7 times more likely to progress (P = .002). A larger proportion of glaucomatous eyes showed central VF progression rather than peripheral VF progression in the DH group (30.8% vs. 20.5%) compared with the non-DH group (10.9% vs. 9.2%). In early glaucoma, the rate of 10-2 MD loss was 5.5 times faster in DH eyes than in non-DH eyes (P < .001). Superonasal and superotemporal central VF regions progressed more rapidly than other regions, especially in DH eyes. CONCLUSION Central VF loss is accelerated in glaucoma eyes with DH and it corresponds topographically to the DH location. In patients with glaucoma with DH, one should consider supplementing 10-2 VFs with 24-2 VFS to monitor the disease.
Collapse
Affiliation(s)
- Ryan Caezar C David
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Jiun L Do
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Huiyuan Hou
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - James Proudfoot
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Linda M Zangwill
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Alireza Kamalipour
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Takashi Nishida
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory (C.G.D.M., J.M.L.), Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Christopher A Girkin
- and the Bernard School of Medicine (C.A.G.), University of Alabama-Birmingham, AL, United States
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory (C.G.D.M., J.M.L.), Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center (R.C.C.D., S.M., J.L.D., H.H., J.P., L.M.Z., A.K., T.N., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
| |
Collapse
|
3
|
The Effect of Ametropia on Glaucomatous Visual Field Loss. J Clin Med 2021; 10:jcm10132796. [PMID: 34202033 PMCID: PMC8268842 DOI: 10.3390/jcm10132796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/02/2022] Open
Abstract
Myopia has been discussed as a risk factor for glaucoma. In this study, we characterized the relationship between ametropia and patterns of visual field (VF) loss in glaucoma. Reliable automated VFs (SITA Standard 24-2) of 120,019 eyes from 70,495 patients were selected from five academic institutions. The pattern deviation (PD) at each VF location was modeled by linear regression with ametropia (defined as spherical equivalent (SE) starting from extreme high myopia), mean deviation (MD), and their interaction (SE × MD) as regressors. Myopia was associated with decreased PD at the paracentral and temporal VF locations, whereas hyperopia was associated with decreased PD at the Bjerrum and nasal step locations. The severity of VF loss modulated the effect of ametropia: with decreasing MD and SE, paracentral/nasal step regions became more depressed and Bjerrum/temporal regions less depressed. Increasing degree of myopia was positively correlated with VF depression at four central points, and the correlation became stronger with increasing VF loss severity. With worsening VF loss, myopes have increased VF depressions at the paracentral and nasal step regions, while hyperopes have increased depressions at the Bjerrum and temporal locations. Clinicians should be aware of these effects of ametropia when interpreting VF loss.
Collapse
|
4
|
Li Y, Guo C, Huang C, Jing L, Huang Y, Zhou R, Qiu K, Zhang M. Development and Evaluation of the Prognostic Nomogram to Predict Refractive Error in Patients With Primary Angle-Closure Glaucoma Who Underwent Cataract Surgery Combined With Goniosynechialysis. Front Med (Lausanne) 2021; 8:749903. [PMID: 34977061 PMCID: PMC8714900 DOI: 10.3389/fmed.2021.749903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/18/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: To evaluate the accuracy of different intraocular lens (IOL) power calculation formulas and develop prognostic nomograms to predict the risk of postoperative refractive error in primary angle-closure glaucoma (PACG) patients. Methods: A total of 111 eyes with PACG underwent goniosynechialysis combined with phacoemulsification and IOL implantation were included. SRK/T, Barrett II, Hoffer Q, and Kane formulas were used to predict postoperative refraction. Prediction error (PE) and absolute predictive error (APE) produced by the four formulas were calculated and compared. An APE >0.50 D was defined as the event. Binary logistic regression analysis and prognostic nomogram models were conducted to investigate reliable predictors associated with postoperative refraction. Results: The Kane (-0.06 D) and Barrett II (-0.07 D) formulas had mean prediction error close to zero (p = 0.44, p = 0.41, respectively). The Hoffer Q and SRK/T produced significantly myopic outcomes (p = 0.003, p = 0.013, respectively). The percentage of eyes within ± 0.5 D was 49.5% (55/111), 44.1% (49/111), 43.2% (48/111), and 49.5% (54/111), for the Kane, Barrett II, Hoffer Q, and SRK/T formula, respectively. Nomogram showed that AL had the greatest impact on the refractive outcomes, indicating a shorter preoperative AL is associated with a greater probability of refractive error event. The area under the receiver operator curve (AUC) of the nomogram for the Kane, Barrett II, Hoffer Q, and SRK/T was 0.690, 0.701, 0.708, and 0.676, respectively. Conclusions: The Kane and Barrett II formulas were comparable, and they outperformed Hoffer Q and SRK/T in the total eyes with PACG receiving cataract surgery combined with goniosynechialysis. The developed nomogram models can effectively predict the occurrence of postoperative refractive error events.
Collapse
Affiliation(s)
- Yuancun Li
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Chengyao Guo
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Chukai Huang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
| | - Liu Jing
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Yingzi Huang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Ruiqing Zhou
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- Kunliang Qiu ; orcid.org/0000-0003-4414-9758
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, China
- *Correspondence: Mingzhi Zhang ; orcid.org/0000-0001-9032-7274
| |
Collapse
|
6
|
Yamamoto T. The impact of disc hemorrhage studies on our understanding of glaucoma: a systematic review 50 years after the rediscovery of disc hemorrhage. Jpn J Ophthalmol 2018; 63:7-25. [PMID: 30465174 DOI: 10.1007/s10384-018-0641-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/19/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW To trace the influence of disc hemorrhage studies on our understanding of glaucoma. SOURCES Major articles published during the last 50 years since the rediscovery of disc hemorrhage were identified. A total of 196 articles were selected from 435 articles retrieved using the keywords glaucoma and disc hemorrhage as of August 9 2018 from PubMed. RECENT FINDINGS The main characteristics of disc hemorrhage, including its morphology, recurrence rate, duration, increased incidence in glaucoma, and role in the progression of normal tension glaucoma was well understood by the year 2000. Since then, studies have focused on more sophisticated and accurate methods of elucidating both structural and functional progression, with special attention to the role of the lamina cribrosa. Nevertheless, both the mechanism of disc hemorrhage development and its fuller relationship with glaucoma remain unclear. Disc hemorrhage research requires careful study of glaucomatous optic neuropathy. This has been facilitated by recent advances in optical coherence tomography (OCT) angiography and other OCT technologies. Furthermore, animal studies of disc hemorrhage promise new insights into glaucomatous optic neuropathy.
Collapse
Affiliation(s)
- Tetsuya Yamamoto
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, 501-1194, Japan.
| |
Collapse
|