Ophthalmology, New York University School of Medicine, New York, NY, USA.
Graefes Arch Clin Exp Ophthalmol. 2010 Jun;248(6):839-44. doi: 10.1007/s00417-010-1306-0. Epub 2010 Feb 25.
To determine whether recurrent disc hemorrhage (DH) accelerates glaucomatous visual field (VF) loss compared to an isolated, single, detected DH.
We evaluated the disc photographs of consecutive patients with >/=5 SITA-Standard fields for DH. Group A had patients with a single DH in one eye, and group B had at least one recurrence in the same eye. Automated pointwise linear regression analysis was used to calculate rates of progression. Logistic regression was used to determine ocular or systemic variables associated with DH recurrence after baseline assessment.
One hundred and seventeen patients were enrolled (group A = 72, group B = 45). The mean age was 67.1 +/- 10.8 years; most patients were women (65%) of European ancestry (92%) diagnosed with primary open-angle glaucoma (47%). The mean number of VF after the initial DH was 7.9 +/- 2.9, spanning a mean of 4.6 +/- 2.2 years. None of the ocular or systemic characteristics revealed a significant difference between groups. The mean global rate of progression (group A, -0.8 +/- 0.6 vs group B, -0.8 +/- 0.7 dB/year, p = 0.93) and number of eyes reaching a progression endpoint (group A, 70% vs group B, 73%, p = 0.80) did not differ between groups. Recurrent DH eyes showed a tendency to be followed longer, with a greater number of disc photographs, which was not significant in the multivariate analysis. The global rates of progression between groups remained non-significant even after adjusting to follow-up time and number of VF tests (p = 0.69).
Recurrent DH does not result in a faster rate of VF progression compared to a single detected DH. Eyes with single or recurrent DH have similar risks for future disease progression.
确定复发性盘出血 (DH) 是否比孤立的、单次的、已检测到的 DH 更快地导致青光眼视野 (VF) 丧失。
我们评估了连续患有 >/=5 个 SITA-标准视野的患者的盘照片，以确定 DH。A 组患者的一只眼有单次 DH，B 组患者的同一只眼至少有一次复发。使用自动逐点线性回归分析来计算进展率。使用逻辑回归来确定基线评估后与 DH 复发相关的眼部或系统性变量。
共纳入 117 例患者（A 组 = 72 例，B 组 = 45 例）。平均年龄为 67.1 +/- 10.8 岁；大多数患者为女性（65%），欧洲裔（92%），原发性开角型青光眼（47%）。首次 DH 后平均 VF 数为 7.9 +/- 2.9，平均随访时间为 4.6 +/- 2.2 年。两组之间在眼部或系统性特征方面没有显著差异。平均全球进展率（A 组，-0.8 +/- 0.6 vs B 组，-0.8 +/- 0.7 dB/年，p = 0.93）和达到进展终点的眼数（A 组，70% vs B 组，73%，p = 0.80）两组之间没有差异。复发性 DH 眼的随访时间较长，眼底照片数量较多，但在多变量分析中无统计学意义。即使在调整随访时间和 VF 测试次数后，两组之间的全球进展率仍然没有统计学意义（p = 0.69）。
与单次检测到的 DH 相比，复发性 DH 不会导致 VF 进展更快。单次或复发性 DH 眼发生未来疾病进展的风险相似。
