Researchers recently discovered that glaucoma patients with optic disc hemorrhage (ODH) experience faster visual field progression than those with no hemorrhage, and it only gets worse the more ODH observed.

The study, published in Ophthalmology Glaucoma, included 151 eyes from 77 patients with bilateral glaucoma or unilateral glaucoma with a fellow glaucoma suspect eye. The researchers used data from optic disc photography every three months and standard automated perimetry every four months and divided disc images into eight sectors to match those of the visual field.

Over an average of 64 months, they found eyes with ODH in two different disc sectors showed worse progression rates than eyes with either ODH in one sector or no hemorrhages at all. In addition, the optic disc sectors with one hemorrhage experienced a faster visual field progression rate than those with no ODH—and that one sector progressed at a similar rate as those with between two and eight hemorrhages. Nine or more ODHs led to the worst visual field progression.

“ODH occurring in different sectors in the same eye were more strongly associated with greater global VF progression compared to those occurring within the same sector,” the researchers added in their paper.

An D, House P, Barry C, et al. Recurrent optic disc hemorrhage and its association with visual field deterioration in glaucoma. Ophthalmol Glaucoma. June 9, 2020. [Epub ahead of print].