Glaucoma Progression After the First-detected Optic Disc Hemorrhage by Optical Coherence Tomography

Purpose: To evaluate the progression of glaucoma after first detected disc hemorrhage (DH) by time-domain optical coherence tomography (OCT). Methods: Forty-four eyes with a unilateral DH were allocated to the DH group and 44 fellow eyes to the non-DH group. OCT signal decrease indicating retinal nerve fiber layer thinning was defined as a decrease beyond the upper 95% limit of test-retest variability defined at the 95% confidence level of 44 control patients. The DH and non-DH groups were compared in terms of OCT-derived glaucoma progressions after the first detected DH. In addition, clock-hour locations of the OCT-derived progression were compared with those of DHs. Results: After a median 38.8 +/- 10.8 months of follow-up, 72.7% (32 of 44) of eyes in the DH group showed OCT-determined progression on a clock-hour basis, compared with 27.3% (12 of 44) of the fellow eyes in the non-DH group (P < 0.0001, Fisher exact test). Eyes in the DH group showed more rapid and greater falls in clock-hour-based progression than fellow eyes in the non-DH group (P < 0.0001, log-rank test). Twenty-nine eyes (90.6%) showed progression within 1 clock hour of the location of DH. However, no significant intergroup differences were observed in terms of OCT-determined progression on quadrant or average basis (P > 0.05, respectively, Fisher exact test). Conclusions: Rapid, spatially compatible, localized thinning of the retinal nerve fiber layer after the first detected DH was shown by Stratus OCT.