TY - JOUR
T1 - Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study
AU - Furlanetto, Rafael L.
AU - De Moraes, Carlos Gustavo
AU - Teng, Christopher C.
AU - Liebmann, Jeffrey M.
AU - Greenfield, David S.
AU - Gardiner, Stuart K.
AU - Ritch, Robert
AU - Krupin, Theodore
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and the following were reported. Dr Liebmann is a consultant to Alcon Laboratories, Inc, Allergan, Inc, Diopsys Corporation, Merz Pharmaceuticals, Inc, Optovue, Inc, Quark Pharmaceuticals, Inc, and Topcon Medical Systems and receives financial support Carl Zeiss Meditec, Diopsys Corporation, Heidelberg Engineering, Optovue, Inc, and Topcon Medical Systems. Dr Greenfield is a consultant to Allergan, Inc, Alcon, Inc, Topcon, Inc, Merz, and SOLX and receives financial support from Carl Zeiss Meditec, Optovue, and Heidelberg Engineering. Dr Ritch is a consultant to iSonic, Aeon Astron, Drais Pharmaceutical, and Medacorp; receives lecture fees from Pfizer and Merck; and holds patents or receives royalties from Ocular Instruments, Inc. Dr Krupin is a consultant to Allergan, Inc. Supported by Allergan, Inc, Irvine, California; the Chicago Center for Vision Research, Chicago, Illinois; Research to Prevent Blindness, Inc, New York, New York; Ralph and Sylvia Ablon Research Fund of the New York Glaucoma Research Institute, New York, New York. Dr Furlanetto was supported by the James Cox Chambers Research Fund of the New York Eye and Ear Infirmary, New York, New York and a CAPES Foundation scholarship from the Ministry of Education of Brazil (BEX no. 9033-11-4) . Dr De Moraes is the Edith C. Blum Foundation Research Scientist, New York Glaucoma Research Institute, New York, New York. Dr Liebmann was supported by the National Eye Institute, National Institutes of Health, Bethesda, Maryland, and the New York Glaucoma Research Institute, New York, New York. Dr Greenfield was supported by the National Eye Institute, National Institutes of Health, Bethesda, Maryland. Study medications were provided by Allergan, Inc. None of the sponsors had any influence on reporting of this study. Involved in Design and conduct of study (T.K., R.R., J.M.L., D.S.G.); Collection, management, analysis, and interpretation of data (T.K., R.R., J.M.L., D.S.G., S.K.G., C.G.D.M., R.L.F.); and Preparation, review, or approval of manuscript (T.K., R.R., J.M.L., D.S.G., S.K.G., C.G.D.M., R.L.F.). The institutional review boards at all 13 participating centers approved the prospective study protocol, and patients gave informed consent to participate in this research study. Clinical trial ( www.clinicaltrials.gov ) identification no. NCT00317577 .
PY - 2014/5
Y1 - 2014/5
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84898899368&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2014.02.009
DO - 10.1016/j.ajo.2014.02.009
M3 - Article
C2 - 24513094
AN - SCOPUS:84898899368
SN - 0002-9394
VL - 157
SP - 945-952.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -