DETERIORATION OF VISUAL-FIELDS IN PATIENTS WITH GLAUCOMA WITH AND WITHOUT OPTIC DISC HEMORRHAGES

Objective: To evaluate visual field deterioration in patients with gla ucoma with and without optic disc hemorrhages (DHs). Design: A prospec tive study at quarterly base involving annual perimetry; mean follow-u p of 9 years. Setting: Outpatient department, nonreferral basis. Patie nts: Sixty-eight patients with primary open-angle glaucoma, 34 with no rmal pressure glaucoma (NPG), and 125 with ocular hypertension. Result s: Visual field deterioration occurred in 32%, 32%, and 6% of the pati ents without DHs who had NPG, primary open-angle glaucoma, or ocular h ypertension, respectively, while visual field deterioration occurred i n 80%, 89%, and 14% of patients with DH, respectively. Cox proportiona l hazards ratio(CHR) for deterioration in patients with vs patients wi thout DHs was 5.4 for NPG (P<.01) and 3.6 for primary open-angle glauc oma (P<.01). In patients with NPG and DHs, ipsilateral eyes with DHs d eteriorated in 58%, while contralateral eyes without DHs deteriorated in 11% (CHR, 8.9; P<.04). For primary open-angle glaucoma and ocular h ypertension, progression did not differ between eyes with DHs and cont ralateral eyes without DHs. Mean (+/-SD) interval between DHs and ipsi lateral visual field deterioration was 3.1+/-1.7 years. No difference in the proportion of eyes progressing after single or recurrent DHs wa s noted. The position of DHs was related to the site of the visual fie ld loss in 44% of the eyes. Conclusions: The presence of DHs increased the risk of visual field deterioration. Disc hemorrhages were indicat ive only of deterioration in ipsilateral eyes-in patients with NPG.