Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma

PURPOSE: We investigated the relationship between disk hemorrhage in normal tension glaucoma and the progression of visual field defects and, additionally, whether hemorrhage plays a role in the pathogenic process of the chronic disease. METHODS: We retrospectively reviewed the charts of 70 patients with normal tension glaucoma (mean followup, 5.6 years) who were not medicated for glaucoma, and we applied a regression analysis of survival data based on the Cox proportional hazards model. Several clinical factors were investigated to find a possible association with the progression of glaucomatous visual field defined by two different definitions: one by mean deviation change and the other by glaucoma change probability analysis. visual field loss in 65.4% of progressive patients with disk hemorrhage, CONCLUSIONS: Several clinical factors other than intraocular pressure are significantly associated with the progression of visual field loss during the natural course of normal-tension glaucoma. Among these, disk hemorrhage is a significantly negative prognostic factor in patients with normal tension glaucoma and may be a sign of progressive damage of the retinal nerve fiber layer, leading to functional deterioration of the visual field. (C) 2000 by Elsevier Science Inc. All rights reserved.