Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study

Rafael L. Furlanetto, Carlos Gustavo De Moraes, Christopher C. Teng, Jeffrey M. Liebmann, David Greenfield, Stuart K. Gardiner, Robert Ritch, Theodore Krupin

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Abstract

Purpose To investigate risk factors for disc hemorrhage detection in the Low-Pressure Glaucoma Treatment Study. Design Cohort of a randomized, double-masked, multicenter clinical trial. Methods Low-Pressure Glaucoma Treatment Study patients with at least 16 months of follow-up were included. Exclusion criteria included untreated intraocular pressure (IOP) of more than 21 mm Hg, visual field mean deviation worse than -16 dB, or contraindications to study medications. Patients were randomized to topical treatment with timolol 0.5% or brimonidine 0.2%. Stereophotographs were reviewed independently by 2 masked graders searching for disc hemorrhages. The main outcomes investigated were the detection of disc hemorrhage at any time during follow-up and their recurrence. Ocular and systemic risk factors for disc hemorrhage detection were analyzed using the Cox proportional hazards model and were tested further for independence in a multivariate model. Results Two hundred fifty-three eyes of 127 subjects (mean age, 64.7 ± 10.9 years; women, 58%; European ancestry, 71%) followed up for an average ± standard deviation of 40.6 ± 12 months were included. In the multivariate analysis, history of migraine (hazard ratio [HR], 5.737; P =.012), narrower neuroretinal rim width at baseline (HR, 2.91; P =.048), use of systemic β-blockers (HR, 5.585; P =.036), low mean systolic blood pressure (HR, 1.06; P =.02), and low mean arterial ocular perfusion pressure during follow-up (HR, 1.172; P =.007) were significant and independent risk factors for disc hemorrhage detection. Treatment randomization was not associated with either the occurrence or recurrence of disc hemorrhages. Conclusions In this cohort of Low-Pressure Glaucoma Treatment Study patients, migraine, baseline narrower neuroretinal rim width, low systolic blood pressure and mean arterial ocular perfusion pressure, and use of systemic β-blockers were risk factors for disc hemorrhage detection. Randomization assignment did not influence the frequency of disc hemorrhage detection.

Original languageEnglish
JournalAmerican Journal of Ophthalmology
Volume157
Issue number5
DOIs
StatePublished - Jan 1 2014

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Optic Disk
Glaucoma
Hemorrhage
Pressure
Therapeutics
Random Allocation
Blood Pressure
Migraine Disorders
Perfusion
Recurrence
Timolol
Visual Fields
Intraocular Pressure
Proportional Hazards Models
Hypotension
Multicenter Studies
Multivariate Analysis
Clinical Trials

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Furlanetto, R. L., De Moraes, C. G., Teng, C. C., Liebmann, J. M., Greenfield, D., Gardiner, S. K., ... Krupin, T. (2014). Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study. American Journal of Ophthalmology, 157(5). https://doi.org/10.1016/j.ajo.2014.02.009

Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study. / Furlanetto, Rafael L.; De Moraes, Carlos Gustavo; Teng, Christopher C.; Liebmann, Jeffrey M.; Greenfield, David; Gardiner, Stuart K.; Ritch, Robert; Krupin, Theodore.

In: American Journal of Ophthalmology, Vol. 157, No. 5, 01.01.2014.

Research output: Contribution to journalArticle

Furlanetto, RL, De Moraes, CG, Teng, CC, Liebmann, JM, Greenfield, D, Gardiner, SK, Ritch, R & Krupin, T 2014, 'Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study', American Journal of Ophthalmology, vol. 157, no. 5. https://doi.org/10.1016/j.ajo.2014.02.009
Furlanetto, Rafael L. ; De Moraes, Carlos Gustavo ; Teng, Christopher C. ; Liebmann, Jeffrey M. ; Greenfield, David ; Gardiner, Stuart K. ; Ritch, Robert ; Krupin, Theodore. / Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study. In: American Journal of Ophthalmology. 2014 ; Vol. 157, No. 5.
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AU - De Moraes, Carlos Gustavo

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AU - Greenfield, David

AU - Gardiner, Stuart K.

AU - Ritch, Robert

AU - Krupin, Theodore

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