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 S Greenfield, Stuart K Gardiner, Robert Ritch, Theodore Krupin, Low-Pressure Glaucoma Treatment Study Group, Lisa F Rosenberg, Jon M Ruderman, John W Yang, Celso Tello, Jeffrey M Liebmann, Robert Ritch, Jonathan S Myers, L Jay Katz, George L Spaeth, Richard P Wilson, Marlene R Moster, Louis B Cantor, Ronald L Gross, Monte S Dirks, Steven R Grimes, David S Greenfield, Harmohina Bagga, Mark B Sherwood, Marianne E Feitl, J Charles Henry, David K Gieser, Jody R Piltz-Seymour, Rafael L Furlanetto, Carlos Gustavo De Moraes, Christopher C Teng, Jeffrey M Liebmann, David S Greenfield, Stuart K Gardiner, Robert Ritch, Theodore Krupin, Low-Pressure Glaucoma Treatment Study Group, Lisa F Rosenberg, Jon M Ruderman, John W Yang, Celso Tello, Jeffrey M Liebmann, Robert Ritch, Jonathan S Myers, L Jay Katz, George L Spaeth, Richard P Wilson, Marlene R Moster, Louis B Cantor, Ronald L Gross, Monte S Dirks, Steven R Grimes, David S Greenfield, Harmohina Bagga, Mark B Sherwood, Marianne E Feitl, J Charles Henry, David K Gieser, Jody R Piltz-Seymour
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.
Trial registration: ClinicalTrials.gov NCT00317577.
Copyright © 2014 Elsevier Inc. All rights reserved.
Source: PubMed