Rate of visual field progression in eyes with optic disc hemorrhages in the ocular hypertension treatment study.

OBJECTIVE: To compare rates of visual field (VF) change in ocular hypertensive eyes with and without optic dischemorrhage (DH).

METHODS: Ocular Hypertension Treatment Study subjects(minimum 10 reliable VF tests, followed up 5 years) were included. Trend analyses of VF sequences over time of DH and non-DH eyes were assessed by regression of mean deviation (MDR) and pointwise linear regression (PLR). The main outcome measures were rates of VF change in DH and non-DH eyes.

RESULTS: Two thousand six hundred seven eyes (1378 participants) were included. The mean (SD) number of VF tests per eye was 23.7 (4.9) spanning a mean (SD) of 12.2 (2.0) years. At least 1 DH was detected in 187 eyes(7.2%), of which 52 eyes had recurrent DH. Mean deviation rate of change was significantly worse in DH compared with non-DH eyes (mean [SD], −0.17 [0.27] vs−0.07 [0.19] dB/y; P<.01). Significant PLR progression occurred more frequently in eyes with DH (odds ratio,3.6; P<.01), which increased when 2 or more DHs were present (odds ratio, 4.2; P=.01). Eyes initially randomized to treatment were less likely to have a DH during follow-up.

CONCLUSIONS: Eyes with DH had more rapid VF deterioration when assessed by global (MDR) or local (PLR)trend analysis than eyes without DH. Eyes with recurrent DH had similar rates of global VF change (MDR)when compared with eyes with a single DH but reached criteria for rapid PLR change more often. Intraocular pressure reduction in ocular hypertension reduces the risk of developing a DH. Ocular hypertensive eyes with DH should be monitored closely and may need more aggressive therapy.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000125