Abstract
Objective
To determine the relationship between optic disc hemorrhage (DH) and corneal hysteresis
(CH).
Methods
Consecutive patients with prior or current photographic evidence of unilateral DH
who had undergone CH measurement with the Ocular Response Analyzer (ORA; Reichert,
Buffalo, NY) were enrolled. Eyes with a history of corneal disease, refractive surgery,
or bilateral DH were excluded. Central corneal thickness (CCT), visual field data,
5 consecutive previous intraocular pressures (IOPs), and maximum documented peak IOP
were obtained by chart review. Vertical cup-to-disc ratio (VCDR), the presence of
neuroretinal rim notching, number of clock hours of beta zone parapapillary atrophy
(ßPPA), and eye with greater ßPPA width were determined from photographs by 2 masked
expert examiners.
Results
We identified and analyzed 49 patients with photographically documented unilateral
DH. Compared to fellow non-DH eyes, eyes with DH had lower CH (8.7 ± 1.9 vs 9.2 ±
1.7; p = 0.002), higher IOP (15.6 ± 3.6 vs 14.3 ± 4.1; p = 0.017), and greater VCDR (0.79 ± 0.13 vs 0.68 ± 0.23; p < 0.001), but were similar with respect to CCT, ßPPA extent, rim notching, peak IOP,
and visual field damage (all p > 0.05). Using multivariate conditional logistic regression analysis, only CH (p = 0.012) and VCDR (p = 0.004) predicted the laterality of the DH.
Conclusions
Lower CH and greater VCDR are independently associated with DH. This suggests that
CH may be a structural biomarker for an abnormality of the optic nerve complex that
may be associated with progressive glaucoma. Eyes in which DH were detected had lower
CH.
Résumé
Objectif
Déterminer le lien entre l'hémorragie discale (HD) et l'hystérèse cornéenne (HC).
Méthodes
Ont été recrutés des patients consécutifs qui présentaient des signes photographiques
(actuels ou antérieurs) d'HD unilatérale et chez lesquels on a mesuré l'HC grâce à
l’Ocular Response Analyzer® (ORA; Reichert, Buffalo, NY). Les yeux qui présentaient des antécédents d'atteinte
cornéenne, de chirurgie réfractive ou d'HD bilatérale ont été exclus. On a consulté
les dossiers médicaux pour obtenir l’épaisseur cornéenne centrale (ECC), les données
liées aux champs visuels, les 5 pressions intraoculaires (PIO) consécutives précédentes
et le pic maximal de PIO enregistré. À partir de photographies à l'insu, 2 examinateurs
experts ont déterminé le rapport cupule/disque (C/D) vertical, la présence d'une encoche
de l'anneau neurorétinien, le nombre d'heures d'horloge de l'atrophie péripapillaire
de la zone β (APPβ) de même que les yeux qui présentaient une APPβ plus importante.
Résultats
Nous avons ainsi identifié et analysé 49 patients qui présentaient des signes photographiques
d'HD unilatérale. Par comparaison aux yeux sans HD, les yeux qui présentaient une
HD avaient une HC moindre (8,7 ± 1,9 vs 9,2 ± 1,7; p = 0,002), une PIO plus élevée
(15,6 ± 3,6 vs 14,3 ± 4,1; p = 0,017) et un plus grand rapport C/D vertical (0,79 ± 0,13 vs 0,68 ± 0,23; p < 0,001); par contre, ces derniers étaient similaires quant à l'ECC, à l’étendue
de l'APPβ, à la présence d'une encoche de l'anneau neurorétinien, au pic de PIO et
aux altérations du champ visuel (p > 0,05 dans tous les cas). Selon la régression logistique conditionnelle pour analyse
multivariée, seule l'HC (p = 0,012) et le rapport C/D vertical (p = 0,004) ont permis de prédire la latéralité de l'HD.
Conclusions
Il existe un lien indépendant entre l'HD, d'une part et une HC moindre et un plus
grand rapport C/D vertical, d'autre part, ce qui donne à penser que l'HC représente
peut-être un biomarqueur structurel d'une anomalie du nerf optique qui pourrait être
associée à un glaucome progressif. Les yeux qui présentaient une HD avaient une HC
moins prononcée.
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Article Info
Publication History
Published online: December 23, 2019
Accepted:
October 24,
2019
Received in revised form:
October 16,
2019
Received:
April 30,
2019
Identification
Copyright
© 2019 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.