OPTIC DISC HEMORRHAGES AND VASCULAR ABNORMALITIES IN A GLAUCOMA POPULATION

Purpose: To retrospectively examine the optic disc photographs of a gl aucoma population for optic disc haemorrhages, vascular occlusions and vascular abnormalities. Methods: The optic disc photographs of 906 ey es of glaucoma and suspect glaucoma patients were examined. Optic disc photographs were taken annually, where possible, with the follow-up p eriod varying between 1 and 14 years duration (mean, 2.89). Glaucoma p atients are regularly reviewed every 4-6 months and glaucoma suspects every 1-2 years, depending on the ophthalmologist. Low-tension glaucom a patients were reviewed more frequently (mean, every 26 months). The results of the findings were compared to a control group of 39 subject s with a mean follow-up period of 7 years, using Fisher's exact test. Results: It was found that during the period under review, 7.4% (n = 6 7) of eyes had optic disc haemorrhages. The highest frequency of optic disc haemorrhages (37.5%) was found in the low tension glaucoma group (P = 0.0001) followed by 11.4% of primary open-angle glaucoma eyes (P = 0.03). In the normal group there were three eyes with optic disc ha emorrhages and one with a disc collateral, which constitutes 5.1% vasc ular changes in this sub-group. Of the study eyes 2.8% had central ret inal vein occlusions, 1.3% branch vein occlusion, 1.2% disc vessel abn ormalities (loops) and 1.1% disc collaterals. Discrete nerve fibre lay er haemorrhages and microaneurysms were found in 0.8% and 1.8% of eyes , respectively. Conclusions: A total of 16.8% of the eyes observed in this study had either disc haemorrhages or vascular changes. The under lying trend of vascular and haemorrhagic changes in glaucoma are demon strated in this sample, which is in general agreement with previous st udies. The high percentage of optic disc haemorrhages in low tension g laucoma is highlighted. The presence of microaneurysms and nerve fibre layer haemorrhages is interesting but of unknown significance.