Abstract
To develop a nomogram to predict the progression of glaucoma by fundus photography in patients with disc hemorrhage. Retrospective review of the medical records of patients with disc hemorrhage, which was detected during follow up with open angle glaucoma, from January 2010 to March 2018. Patients were divided into glaucoma progression (n = 52) or non-progression (n = 38) groups. We assessed proximal location and morphology of disc hemorrhage; relationship to retinal nerve fiber layer defects with disc hemorrhage; and angular extent of disc hemorrhage, between groups using fundus photography. Multiple logistic regression analysis was performed to select prognostic factors, and we constructed a nomogram to predict glaucoma progression. The number of disc hemorrhage at the border of retinal nerve fiber layer defects (P = 0.001) and peripapillary disc hemorrhage (P = 0.008) were significantly higher in the progression group. We used angular extent; location of disc hemorrhage with retinal nerve fiber layer defects; and proximal location of disc hemorrhage to construct the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.847. We created the nomogram using fundus photography in patients showing disc hemorrhage as a novel and accurate screening method to predict glaucoma progression and aid clinicians to decide on the best treatment plan.
Highlights
To develop a nomogram to predict the progression of glaucoma by fundus photography in patients with disc hemorrhage
Regarding the characteristics of Disc hemorrhage (DH), there were no significant differences in recurrence rate, bilaterality, duration of DH, angular extent of DH, and octant location of DH between the groups (Table 2)
In terms of the positional relationship between DH and retinal nerve fiber layer defects (RNFLD), DH at the border of RNFLD was observed in 81.4% and 37.1% and DH at a location without RNFLD found in 6.9% and 45.7% of eyes in the progression and non-progression group, respectively
Summary
To develop a nomogram to predict the progression of glaucoma by fundus photography in patients with disc hemorrhage. We assessed proximal location and morphology of disc hemorrhage; relationship to retinal nerve fiber layer defects with disc hemorrhage; and angular extent of disc hemorrhage, between groups using fundus photography. We used angular extent; location of disc hemorrhage with retinal nerve fiber layer defects; and proximal location of disc hemorrhage to construct the nomogram. We created the nomogram using fundus photography in patients showing disc hemorrhage as a novel and accurate screening method to predict glaucoma progression and aid clinicians to decide on the best treatment plan. The purpose of this study was to develop a simple and novel tool for predicting the progression of glaucoma using the morphologic findings of DH from fundus photography. We created a nomogram based on a logistic regression model and sought to predict the probability of a particular outcome with a combination of important prognostic factors
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