TY - JOUR
T1 - Anatomic Relationships between Disc Hemorrhage and Parapapillary Atrophy
AU - Radcliffe, Nathan M.
AU - Liebmann, Jeffrey M.
AU - Rozenbaum, Ilya
AU - Sbeity, Zaher
AU - Sandler, Shlomit F.
AU - Tello, Celso
AU - Ritch, Robert
N1 - Funding Information:
This study was supported by the Lowell Harwood Research Fund of the New York Glaucoma Research Institute and the Manhattan Eye, Ear, and Throat Hospital Glaucoma Education and Research Fund, New York, New York. The authors indicate no financial conflict of interest. Involved in conception and design (N.M.R., J.M.L., I.R.); analysis (N.M.R., J.M.L., Z.S.); writing (N.M.R., J.M.L.); critical revision (N.M.R., J.M.L., I.R., S.F.S., R.R.); final approval (N.M.R., J.M.L.); data collection (N.M.R., J.M.L., I.R., Z.S., S.F.S.); provision of materials (N.M.R., J.M.L., C.T., R.R.); statistical expertise (N.M.R., J.M.L., R.R.); obtaining funding (N.M.R., J.M.L., C.T., R.R.); literature search (N.M.R., J.M.L., I.R., S.S.); and administrative support (N.M.R., J.M.L.). Approval for this Health Insurance Portability and Accountability Act-compliant study was obtained from the New York Eye and Ear Infirmary Institutional Review Board.
PY - 2008/11
Y1 - 2008/11
N2 - Purpose: Parapapillary atrophy (PPA) and disc hemorrhage (DH) are associated with glaucoma. We sought to determine whether they are anatomically related. Design: Retrospective study. Methods: All digital optic nerve stereophotographs obtained over a one-year period were screened for the presence of DH. Only patients with DH were included. The location of the greatest β zone PPA width as defined by the radial distance between the scleral rim and the outer border of the β zone was compared in each patient. The clock hour location of the DH was determined. Baseline central corneal thickness, intraocular pressure, vertical cup-to-disc ratio, and visual field indices were obtained. Results: Photographs from 1,559 glaucoma patients were evaluated and 46 eyes with unilateral DH were identified; 42 (91.3%) had β zone PPA and 38 eyes had asymmetric PPA width. DH occurred more frequently in the eye with the greater PPA width (29/38 eyes [76.3%]; κ = 0.611; P < .001). The DH fell on the point of greatest PPA width in 10 (23.9%) of 42 eyes (P < .05, Fisher exact test) and within two clock hours of the greatest PPA width in 31 (73.8%) of 42 eyes (P < .001, Chi-square test). Logistic regression analysis determined that greater PPA width (odds ratio, 17.16; 95% confidence interval, 5.34 to 55.12; P < .001) was the only ocular characteristic to predict the laterality of the DH. Conclusions: DHs tend to occur in the eye with the greatest PPA width and usually are found within the region of its greatest width.
AB - Purpose: Parapapillary atrophy (PPA) and disc hemorrhage (DH) are associated with glaucoma. We sought to determine whether they are anatomically related. Design: Retrospective study. Methods: All digital optic nerve stereophotographs obtained over a one-year period were screened for the presence of DH. Only patients with DH were included. The location of the greatest β zone PPA width as defined by the radial distance between the scleral rim and the outer border of the β zone was compared in each patient. The clock hour location of the DH was determined. Baseline central corneal thickness, intraocular pressure, vertical cup-to-disc ratio, and visual field indices were obtained. Results: Photographs from 1,559 glaucoma patients were evaluated and 46 eyes with unilateral DH were identified; 42 (91.3%) had β zone PPA and 38 eyes had asymmetric PPA width. DH occurred more frequently in the eye with the greater PPA width (29/38 eyes [76.3%]; κ = 0.611; P < .001). The DH fell on the point of greatest PPA width in 10 (23.9%) of 42 eyes (P < .05, Fisher exact test) and within two clock hours of the greatest PPA width in 31 (73.8%) of 42 eyes (P < .001, Chi-square test). Logistic regression analysis determined that greater PPA width (odds ratio, 17.16; 95% confidence interval, 5.34 to 55.12; P < .001) was the only ocular characteristic to predict the laterality of the DH. Conclusions: DHs tend to occur in the eye with the greatest PPA width and usually are found within the region of its greatest width.
UR - http://www.scopus.com/inward/record.url?scp=54449096632&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2008.06.018
DO - 10.1016/j.ajo.2008.06.018
M3 - Article
C2 - 18723142
AN - SCOPUS:54449096632
SN - 0002-9394
VL - 146
SP - 735-740.e2
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -