Characteristics of Central Visual Field Progression in Eyes with Optic Disc Hemorrhage.

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To investigate the characteristics and rate of central visual field loss after optic disc hemorrhages (DH).Prospective cohort study.343 eyes of 220 subjects who had at least 3 years of follow-up with 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 pre-defined zones were compared using linear mixed-effects model in DH and non-DH eyes. Clustered pointwise regression analysis was also used to define central VF progressors and compared to 24-2 VF loss using Guided Progression Analysis.39 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 mean deviation (MD) loss that were 3 times faster than non-DH eyes (mean difference (95% CI): -0.36 dB/year(0.54, 0.18), p<0.001) and were 3.7 times more likely to progress (p=0.002). A larger proportion of glaucomatous eyes showed central VF progression rather than peripheral VF progression in DH group (30.8% vs. 20.5%) compared to 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<0.001). Superonasal and superotemporal central VF regions progressed more rapidly than other regions, especially in DH eyes.Central visual field loss is accelerated in glaucoma eyes with DH and it corresponds topographically to the DH location. In glaucoma patients with DH, one should consider supplementing 10-2 VFs with 24-2 VFS to monitor the disease.

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Authors: Ryan Caezar C David, Sasan Moghimi, Jiun L Do, Huiyuan Hou, James Proudfoot, Linda M Zangwill, Alireza Kamalipour, Takashi Nishida, Carlos Gustavo De Moraes, Christopher A Girkin, Jeffrey M Liebmann, Robert N Weinreb