Kim Seok Hwan, Park Ki Ho
Department of Ophthalmology, Seoul National University College of Medicine, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, South Korea.
Ophthalmology. 2006 Apr;113(4):598-602. doi: 10.1016/j.ophtha.2005.12.018. Epub 2006 Feb 17.
To compare the clinical characteristics and progression rates of glaucoma in patients with recurrent and single disc hemorrhages (DHs).
Retrospective comparative case series.
Patients with DH.
The medical records of 57 eyes of 54 patients with DH were reviewed retrospectively. These patients had been regularly followed up at 1- to 3-month intervals, between 1991 and 2003, for at least 1 year after the initial DH. The recurrent DH group was composed of patients who had experienced > or =2 episodes of hemorrhage, whereas the single DH group was composed of those who had experienced a single DH episode. These 2 patient groups were compared with respect to clinical courses after initial DH and their clinical characteristics.
Progression of optic disc and visual field (VF) deterioration.
Twenty-six of the eyes in this study (45.6%) exhibited recurrent DH, and 31 eyes (54.4%) single DH. The average total follow-up period in the recurrent DH group was 67.5 months, whereas single DH patients were followed up for an average of 54.7 months. There were no differences between the groups with regard to age, diagnosis, follow-up period, associated disease, or mean deviation in automated perimetry. Normal-tension glaucoma was the most commonly encountered glaucoma type, and the inferotemporal area was the most common location of DH in both groups. The cumulative probability of optic disc deterioration, including retinal nerve fiber layer change after DH, was found to be significantly greater in patients with recurrent DH (P = 0.004, log rank test). However, no significant differences were found between the 2 groups with regard to rate of VF deterioration (P = 0.10, log rank test).
No differences were found between the recurrent and single DH groups in terms of clinical characteristics. Recurrent DH in cases of glaucoma may reflect more rapid optic nerve head damage progression than single DH.
比较复发性和单次视盘出血（DH）患者青光眼的临床特征和进展率。
回顾性比较病例系列研究。
视盘出血患者。
回顾性分析54例视盘出血患者57只眼的病历。这些患者在1991年至2003年间，自首次视盘出血后，每隔1至3个月定期随访至少1年。复发性视盘出血组由经历过≥2次出血发作的患者组成，而单次视盘出血组由经历过单次视盘出血发作的患者组成。比较这两组患者首次视盘出血后的临床病程及其临床特征。
视盘和视野（VF）恶化的进展情况。
本研究中26只眼（45.6%）出现复发性视盘出血，31只眼（54.4%）为单次视盘出血。复发性视盘出血组的平均总随访期为67.5个月，而单次视盘出血患者的平均随访期为54.7个月。两组在年龄、诊断、随访期、相关疾病或自动视野计平均偏差方面无差异。正常眼压性青光眼是最常见的青光眼类型，两组中视盘出血最常见的部位均为颞下区域。发现复发性视盘出血患者视盘恶化的累积概率，包括视盘出血后视网膜神经纤维层的变化，显著更高（P = 0.004，对数秩检验）。然而，两组在视野恶化率方面未发现显著差异（P = 0.10，对数秩检验）。
复发性和单次视盘出血组在临床特征方面未发现差异。青光眼患者的复发性视盘出血可能比单次视盘出血反映出更快速的视神经乳头损害进展。
