Précis: 

Patients with low-tension optic disc hemorrhages (DHs) are more frequently women, have a diagnosis of normal-tension glaucoma (NTG) diagnosis and greater visual field (VF) loss. Symptoms of vascular dysregulation and Asian race also seem to be more prevalent in this clinical subtype.

Purpose: 

Optic DH is an important glaucoma risk factor, and occurs in a wide intraocular pressure (IOP) range. We sought to characterize distinct clinical subtypes of patients with high-tension disc hemorrhage (HTDH) and low-tension disc hemorrhage (LTDH).

Patients and Methods: 

In this cross-sectional study, treated glaucomatous patients with DHs from 2 glaucoma services were consecutively enrolled. Disc photographs were evaluated for the presence of DH by 2 glaucoma specialists. After inclusion, patients were classified on HTDH (IOP≥16 mm Hg) and LTDH (IOP<16 mm Hg; median split). Clinical and ocular data from the time of DH detection were compared between groups.

Results: 

One hundred thirty-three DH patients were included (LTDH=66 eyes; HTDH=67 eyes). Patients with LTDH were more often women than those with HTDH (77% vs. 42%; P=0.030). There was also a trend for a higher prevalence of Asian descendants (24% vs. 9%; P=0.058) and symptoms suggestive of vascular dysregulation (34% vs. 14%; P=0.057) in LTDH patients. Eyes with LTDH also had worse VF mean deviation index (P=0.037), higher prevalence of NTG diagnosis (46% vs. 17%; P<0.001), and tended to have thinner central corneas (P=0.066).

Conclusions: 

Patients developing DHs with treated IOPs in the low teens seem to more frequently fit in a profile represented by women, NTG diagnosis and greater VF loss. The presence of symptoms suggestive of vascular dysregulation and race also seem to differ between these 2 clinical subtypes. A closer optic disc surveillance is recommended for patients with the LTDH subtype, as they may develop DHs despite seemingly well-controlled IOP.

中文翻译：

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高眼压和低眼压视盘出血青光眼患者的临床特征：一项比较研究

概要： 

低眼压性视盘出血(DH) 患者多为女性，被诊断为正常眼压性青光眼 (NTG)，且视野 (VF) 损失较大。血管失调和亚洲人种的症状似乎在这种临床亚型中更为普遍。

目的： 

视神经DH是青光眼的一个重要危险因素，并且发生在很宽的眼压（IOP）范围内。我们试图描述高张力椎间盘出血（HTDH）和低张力椎间盘出血（LTDH）患者的不同临床亚型的特征。

患者和方法： 

在这项横断面研究中，连续招募了来自 2 个青光眼服务机构的 DH 接受治疗的青光眼患者。由 2 名青光眼专家评估视盘照片是否存在 DH。纳入后，患者根据 HTDH（IOP≥16 mm Hg）和 LTDH（IOP<16 mm Hg；中位分裂）进行分类。比较各组之间 DH 检测时的临床和眼部数据。

结果： 

纳入 133 名 DH 患者（LTDH=66 只眼；HTDH=67 只眼）。LTDH 患者中女性多于 HTDH（77% vs. 42%；P =0.030）。LTDH 患者中亚洲后裔的患病率也有较高的趋势（24% vs. 9%；P = 0.058），且提示血管失调的症状（34% vs. 14%；P = 0.057）。患有LTDH的眼睛的VF平均偏差指数也更差（P = 0.037），NTG诊断率更高（46％对17％；P <0.001），并且中央角膜往往更薄（P = 0.066）。

结论： 

在青少年时期接受眼压治疗后出现 DH 的患者似乎更常符合以女性、NTG 诊断和更大的 VF 损失为代表的特征。这两种临床亚型之间提示血管失调和种族的症状似乎也有所不同。建议对 LTDH 亚型患者进行更密切的视盘监测，因为尽管眼压看似控制良好，但他们仍可能出现 DH。