ObjectivesTo determine the positive predictive value (PPV) of disc haemorrhages (DHs) for the diagnosis of open angle glaucoma (OAG).MethodsA retrospective review of 618 consecutive new referrals by community optometrists to a hospital glaucoma service, including 54 patients with DHs. All patients had a comprehensive eye examination. The primary outcome was whether the patient was diagnosed with OAG in either eye, with a secondary outcome of whether they were discharged at the first visit (first visit discharge rate, FVDR).Results54 of 618 patients (8.7%) had a DH noted at the time of referral, including 21 referred with DH alone. 29 patients with DHs were diagnosed with OAG for a PPV of 54% (95% CI 40–67%), falling to 24% (95% CI 8–47%) in those with DH alone. The overall FVDR was 35%, increasing to 57% in those referred due to DH alone. The FVDR for those referred with DH alone was significantly higher than the FDVR of 25% among the 564 patients referred with suspected glaucoma without a DH (P = 0.001). The FVDR decreased to 35% for patients with a DH plus one other feature of glaucoma and to 0% for patients with a DH and at least two other features suggestive of glaucoma.ConclusionsAlmost 60% of patients referred due to isolated DHs were discharged at the first visit to the glaucoma clinic, however almost one in four was diagnosed with OAG. Patients with DH and other features suggestive of glaucoma had a higher probability of glaucoma diagnosis.

中文翻译：

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视盘出血对开角型青光眼的阳性预测价值

目的确定椎间盘出血（DHs）对开角型青光眼（OAG）诊断的阳性预测值（PPV）。方法回顾性回顾了社区验光师对医院青光眼服务机构连续转诊的 618 名患者，包括 54 名 DHs 患者。所有患者均进行了全面的眼科检查。主要结果是患者是否在任何一只眼中被诊断为 OAG，次要结果是他们是否在第一次就诊时出院（首次就诊出院率，FVDR）。结果 618 名患者中的 54 (8.7%) 在转介时间，包括 21 次由卫生署转介。29 名 DH 患者被诊断为 OAG，PPV 为 54% (95% CI 40–67%)，而在单纯 DH 患者中这一比例降至 24% (95% CI 8–47%)。总体 FVDR 为 35%，在仅因 DH 转诊的患者中增加到 57%。在 564 名无 DH 的疑似青光眼患者中，仅接受 DH 转诊的患者的 FVDR 显着高于 25% 的 FDVR（P = 0.001）。对于 DH 加上其他青光眼特征的患者，FVDR 降低至 35%，对于 DH 和至少两种其他提示青光眼特征的患者，FVDR 降低至 0%。结论 几乎 60% 因孤立性 DH 转诊的患者在第一次访问青光眼诊所，但几乎四分之一被诊断出患有 OAG。具有 DH 和其他提示青光眼的特征的患者有更高的青光眼诊断概率。对于 DH 加上其他青光眼特征的患者，FVDR 降低至 35%，对于 DH 和至少两种其他提示青光眼特征的患者，FVDR 降低至 0%。结论 几乎 60% 因孤立性 DH 转诊的患者在第一次访问青光眼诊所，但几乎四分之一被诊断出患有 OAG。具有 DH 和其他提示青光眼的特征的患者有更高的青光眼诊断概率。对于 DH 加上其他青光眼特征的患者，FVDR 降低至 35%，对于 DH 和至少两种其他提示青光眼特征的患者，FVDR 降低至 0%。结论 几乎 60% 因孤立性 DH 转诊的患者在第一次访问青光眼诊所，但几乎四分之一被诊断出患有 OAG。具有 DH 和其他提示青光眼的特征的患者有更高的青光眼诊断概率。