Clinical Significance of the Location of Recurrent Optic Disc Hemorrhage in Glaucoma

PURPOSE. To compare clinical characteristics and visual field (VF) progression between glaucomatous eyes with disc hemorrhage (DH) recurring at the same or different locations in relation to the initial DH location. METHODS. One hundred forty-seven open-angle glaucoma patients with DH who were observed for more than 4 years and had more than six VF tests were included. Disc hemorrhage that recurred at the same location as the initial DH was defined as a DH at the same location, and DH that recurred at a different location was defined as a DH at a different location. Overall rate of VF change using the mean deviation (MD) was compared between groups using a linear mixed model, and Kaplan-Meier survival analysis was performed. RESULTS. Seventy-seven (52.4%) eyes had nonrecurrent DH, and 70 (47.6%) eyes had recurrent DH detected during the follow-up period. Recurrent DH at the same location (-0.32 dB/y) was not significantly different from the nonrecurrent DH group in terms of the rate of VF change (P = 0.116). However, the recurrent DH group at different locations (-1.07 dB/y) had a significantly different rate of VF change compared to the recurrent DH group at the same location (P = 0.014). By Kaplan-Meier analysis, eyes with recurrent DH at different locations showed the fastest time to VF progression compared to other groups (log rank test, P < 0.001). CONCLUSIONS. Eyes with recurrent DH recurring at different locations from initial DH sites had more pronounced VF progression.