Aretrospective correlation between disc hemorrhage and peripapillary atrophy in 44 glaucoma patients with unilateral disc hemorrhage was performed. Thirty-seven patients had normal-tension glaucoma and 7 patients had primary open-angle glaucoma. The topographic measurements were performed using the Heidelberg Retina Tomograph (HRT) within 3 months of detecting the disc hemorrhage. The zone beta parameters of the peripapillary atrophy were analyzed by the Atrophy Zone Analysis software. The area, angular and radial extent of the zone beta, and the ratio of the zone beta area to the disc area were significantly greater in the hemorrhagic eyes than in the contralateral eyes (P < 0.001). The prevalence of peripapillary atrophy was significantly higher in the hemorrhagic eyes (84%) than in the contralateral eyes (66%) (P = 0.034). The rim area and the rim volume of the hemorrhagic eyes were significantly smaller than those of the contralateral eyes (P = 0.02, <0.001, respectively). In multivariate regression analysis, the peripapillary atrophy area was the independent significant factor associated with disc hemorrhage (P = 0.03, Odd Ratio = 1.51). The refractive error, intraocular pressure, mean deviation (MD) and correlated pattern standard deviation (CPSD) of the visual fields in both eyes were similar. The conclusion was that the area and extent of the peripapillary atrophy was significantly greater and more prevalent in the eyes with a disc hemorrhage than in the contralateral control eyes. Peripapillary atrophy is closely associated with a disc hemorrhage in glaucoma patients irrespective of small neuroretinal rim area and volume.—Michael D. Wagoner