联合用药对高眼压型POAG患者视盘参数及视网膜神经纤维层厚度的影响

目的:研究噻吗洛尔与拉坦前列素联合应用对高眼压型原发性开角型青光眼(primary open angle glaucoma,POAG)患者视盘参数及视网膜神经纤维层厚度的影响,为临床研究提供指导.方法:将2013-11/2015-11期间于我院进行治疗的240例336眼高眼压型POAG患者按随机数字表法将患者分为两组,其中对照组120例170眼,观察组120例166眼.对照组患者仅采用拉坦前列素治疗,观察组则采用噻吗洛尔联合拉坦前列素进行治疗.观察治疗后3 mo内患者治疗效果,测量患者视盘参数和视网膜神经纤维层厚度,随访关注1a内患者不良反应发生率.结果:观察组和对照组患者治疗后的改善率分别为97.6%和80.6%,观察组疗效明显优于对照组,两组比较差异有统计学意义(P<0.05);治疗后两组患者眼部盘沿面积、盘沿容积、视盘容积和水平杯盘直径比均有所升高,差异有统计学意义(P<0.05),其中观察组显著高于对照组,差异有统计学意义(P<0.05),而两组患者的垂直杯盘直径明显下降,差异有统计学意义(P<0.05),观察组显著低于对照组,差异具有统计学意义(P<0.05);两组患者治疗期间眼睛干涩、角膜浸润、结膜充血、视觉模糊等并发症发生率比较差异无统计学意义(P>0.05),1a内随访患者也无其他不良反应发生.结论:采用噻吗洛尔与拉坦前列素联合应用治疗高眼压型POAG患者,患者病情有明显好转,视力得到提高,其视盘参数和视网膜神经纤维层厚度也有所改善.     

海德堡激光眼底扫描仪对POAG患者视盘结构的研究分析

目的:评价海德堡激光眼底扫描仪(HRT-Ⅲ)对原发性开角型青光眼(primary open angle glaucoma,POAG)不同发展阶段的诊断能力。方法:采用海德堡激光眼底扫描仪对POAG患者65例116眼和正常人60例114眼进行视盘断层扫描获取视盘结构各参数;将正常人和POAG患者以及各期POAG患者的视盘参数进行对比分析;将POAG患者的视盘结构参数与视野平均缺损值进行相关分析。结果:POAG患者与正常人的视杯面积、盘沿面积、视杯容积、盘沿容积、杯盘面积比、盘沿视盘面积比、线性杯盘比、平均视杯深度、最大视杯深度、平均RNFL厚度的差异有统计学意义。早期、进展期、晚期POAG患者的视杯面积、盘沿面积、视杯容积、盘沿容积、杯盘面积比、盘沿视盘面积比、线性杯盘比、平均视杯深度、平均视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的差异有统计学意义。POAG患者的视杯面积、视杯容积、杯盘面积比、线性杯盘比、平均视杯深度与视野平均缺损值呈正相关,而盘沿面积、盘沿容积、盘沿视盘面积比、平均RNFL厚度则与视野平均缺损值呈负相关。结论:HRTⅢ能够有效地反映POAG各阶段的视盘改变,与视野相关性好,为POAG的诊断提供了依据。     

原发性开角型和闭角型青光眼眼压降低前后视盘改变和筛板顺应性的对比研究

目的比较降跟压前后原发性慢性闭角型青光眼（PACG）与原发性开角型青光眼（POAG）的视盘结构改变,了解两者间筛板顺应性是否存在差异。设计前瞻性对比研究。研究对象PACG36例49眼和POAG35例49眼。方法眼压降低前全部患者进行海德堡视网膜断层扫描（HRT—II）及Humphrey静态视野检查。根据病情选择手术、激光或药物治疗,使眼压降至正常范围。眼压降低后1个月重复HRT检查和视野检查。比较POAG和PACG眼压降低前后HRT视盘参数的变化,采用多元线性逐步回归法校正治疗前眼压、眼压降低幅度、年龄、杯盘比等因素影响。主要指标眼压降低前后HRT视杯面积、盘沿面积、视杯容积、平均视杯深度的差值。结果PACG及POAG组的视杯面积、视杯容积、平均视杯深度等指标在眼压降低后均明显降低（P〈0．05）,盘沿面积在眼压降低后均明显增加（P〈0．05）。视杯面积、盘沿面积、视杯容积、平均视杯深度在跟压降低前后的差值两组间无显著性差异（P〉0．05）。眼压降低前后这4个参数的差值与眼压降低幅度及杯盘比有关（P〈0．05）;与年龄及治疗前眼压无关（P〉0．05）。结论眼压降低后青光眼视盘形态结构有一定回复;但在PACG和POAG间,视盘形态结构回复的程度无明显差异,PACG和POAG的筛板顺应性可能无差异。（眼科,2009,18：264—269）     

傅立叶OCT和海德堡激光眼底扫描仪在开角型青光眼早期诊断中的应用

背景研究表明,视网膜神经纤维层（RNFL）缺损是青光眼早期损害的重要表现,如何准确地定量检测RNFL的厚度变化是青光眼早期诊断及监测青光眼病情进展的关键步骤之一。目的对傅立叶OCT、海德堡激光眼底扫描仪（HRT—Ⅲ）测量青光眼患者的RNFL厚度以及视盘的各项参数进行分析,对二者在青光眼早期诊断中的作用进行临床评价。方法收集可疑开角型青光眼（SOAG）患者26例40眼、原发性开角型青光眼（POAG）患者29例48眼以及正常对照组27例48眼。应用傅立叶OCT、HRT—Ⅲ、Humphrey 750-i型全自动视野计对所有研究对象分别进行视盘面积,视杯面积,杯盘面积比,盘沿面积,盘沿容积,视盘上方、下方、颞侧、鼻侧象限的RNFL厚度等参数测定和视野检查,对不同受检者测得的各项参数进行分析和比较,分别与视野平均缺损值做相关分析,评价不同参数对于青光眼RNFL损伤的诊断价值。结果傅立叶OCT和HTR—Ⅲ检测对正常对照组检查结果均证实RNFL从厚到薄依次为视盘下方、上方、颞侧、鼻侧象限,SOAG组和POAG组RNFL厚度变薄的顺序依次为视盘下方、上方、颞侧、鼻侧象限,各部位厚度改变的差异均有统计学意义（P〈0．05）,SOAG组和POAG组患者盘沿面积、杯盘面积比、视杯面积、盘沿容积与正常对照组比较,差异均有统计学意义（P〈0．05）。对3组患者的检测表明,傅立叶OCT与HTR-Ⅲ检测视盘上方象限、下方象限的测定之间存在着正相关关系（r=0．362、r=0．441、r=0．395,P〈0．05）;2种检查方法所测得3个组视杯容积、视杯面积、盘沿容积、杯盘面积比呈正相关（P〈0．05）。在POAG组中,傅立叶OCT测得视盘参数中的盘沿面积、盘沿容积、视杯容积、杯盘面积比与视野的平均缺损值间的相关系数分别为0．284、0．286、0．340、0．371（P〈0．05）;HRT-Ⅲ测得视盘参数中的盘沿面积、盘沿容积、杯盘面积比与视野的平均缺损值间的相关系数分别为0．339、0．859、0．422（P〈0．05）。结论傅立叶OCT和HRT-Ⅲ检测的视盘参数结果接近,且均与视野的平均缺损值有较好的相关性;所检测杯盘面积比、盘沿面积和视盘上方象限、下方象限的RNFL厚度的改变在青光眼早期诊断中均有重要价值。     

正常眼与原发性开角型青光眼的OCT视盘参数分析的对比研究

目的使用OCT评估正常眼与原发性开角型青光眼(primary open angle glaucoma,POAG)视盘(opticnerve head,ONH)的差异。方法选择具有青光眼性视神经损害或RNFL缺损、相应的视野缺损的开角型青光眼60例(60只眼),另选择正常眼60例(60只眼)作为正常对照组。对二组患者进行详细的眼科检查,并使用光学相干断层扫描仪(optical coherence tomography,OCT)测定视盘形态。OCT检查采用视盘扫描模式,评估数据包括视盘面积、视杯面积、盘沿面积、垂直盘沿面积(vertical integrated rim area,VIRA)、水平盘沿容积、平均杯盘比、水平和垂直杯盘比以及视杯容积。比较二组视盘参数,并比较平均误差(mean deviation,MD)和校正模型标准变异(correc-ted pattern standard deviation CPSD)与青光眼组的视盘参数有无相关。结果原发性开角型青和正常组之间视盘参数的比较具有显著性差异。正常眼、POAG比较分别为:视盘面积(211 /-0.5,2.62 /-0.4)mm2,(P<0.01),视杯面积(0.65 /-0.5,1.79 /-0.6)mm2,(P<0.01),盘沿面积(1.44 /-0.4,0.89 /-0.4)mm2,(P<0.01),VIRA(1.53 /-0.4,1.11 /-0.3)mm2,(P<0.01),盘沿容积(0.42 /-0.1,0.26 /-0.1)mm3,(P<0.061),杯盘比(0.31 /-0.2,0.62 /-0.2),(P<0.01)。结论OCT在开角型青光眼的早期诊断中具有重要价值。     

曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症

目的：研究曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症的降眼压效果及安全性。方法：随机选取2013-03/2016-03我院收治的原发性开角型青光眼和高眼压症患者80例80眼,依据不同治疗方法分为两组：曲伏前列素滴眼液组( n=40)和拉坦前列素滴眼液组(n=40),对两组患者的临床疗效、视力、散光度、眼压及不良反应发生情况进行统计分析。结果：曲伏前列素滴眼液组患者治疗的总有效率95%(38/40)显著高于拉坦前列素滴眼液组80%(32/40),差异有统计学意义(P<0.05)。曲伏前列素滴眼液组患者治疗后视力显著高于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),散光度、眼压均显著低于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),不良反应发生率25%(10/40)显著低于拉坦前列素滴眼液组53%(21/40),差异有统计学意义(P<0.05)。结论：曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症比拉坦前列素滴眼液具有较好的降眼压效果及较高的安全性。     

小梁切除术联合复方血栓通胶囊对急性闭角型青光眼患者视功能的影响

目的：探讨小梁切除术联合复方血栓通胶囊对急性闭角型青光眼患者视功能损害的影响。
　　方法：选取2010-03/2014-10期间我院收治的100例120眼急性闭角型青光眼患者,按照双盲法将其分为观察组和对照组,观察组患者52例60眼行小梁切除术联合复方血栓通胶囊治疗,对照组患者48例60眼行单纯小梁切除术治疗,观察并对比术后3 lo两组患者的视力及视野恢复情况。
　　结果：术后3lo,所有患者眼压降至正常范围,观察组视力较术前增加(0.16±0.02),而对照组增加(0.09±0.01),差异具有统计学意义(P<0.05);观察组的视力疗效总有效率(96.7%)显著高于对照组(83.3%),差异具有统计学意义( P<0.05);观察组视野疗效总有效率为96.7%,明显高于对照组的83.3%,差异具有统计学意义(P<0.05)。观察组并发症发生率(1.7%)明显低于对照组(16.7%),差异具有统计学意义(P<0.05)。
　　结论：小梁切除术联合复方血栓通胶囊治疗急性闭角型青光眼患者,能有效提高其视力、改善视野、降低并发症发生率。     

HRT视盘参数在原发性开角型青光眼早期诊断中的作用

目的:在众多海德堡视网膜断层扫描仪(heidelberg retina tomogragh,HRT)测定的视盘参数中,筛选出最有助于青光眼早期诊断的视盘参数。方法:用HRT测定23例视野损害较轻的青光眼患者和23例正常人的视盘参数(杯盘面积比、盘沿面积、盘沿容积、视杯容积、视杯形态测量、视杯高度变异轮廓和平均神经纤维层厚度)作逐步判别分析。结果:盘沿面积和杯盘面积比对青光眼早期诊断最有帮助,其诊断敏感度和特异度分别为87%和96%。结论:本组资料盘沿面积和杯盘面积比是区分青光眼和正常眼最好的判别因素。     

益精补阳还五汤联合马来酸噻吗洛尔治疗POAG的疗效分析

目的:探讨益精补阳还五汤联合马来酸噻吗洛尔滴眼液对原发性开角型青光眼(POAG)患者眼血供、眼压及视力的影响。方法:选取2018-02/2020-02本院POAG患者120例,依据随机表分为滴眼组(60例,给予马来酸噻吗洛尔滴眼液治疗)和汤液组(60例,给予马来酸噻吗洛尔滴眼液联合益精补阳还五汤治疗),比较两组眼血供[视网膜中央动脉(CRA)和睫状后动脉(PCA)的舒张末期血流速度(EDV)、收缩期峰值血流速度(PSA)、阻力指数(RI)]、眼压、视力、视野[平均视敏度(MS)、平均视野缺损(MD)]、疗效、不良反应。结果:汤液组和滴眼组治疗后CRA和PCA的EDV、PSA及视力、MS明显高于治疗前,汤液组和滴眼组治疗后CRA、PCA的RI及眼压、MD明显低于治疗前,汤液组治疗后CRA和PCA的EDV、PSA及视力、MS明显高于滴眼组,汤液组治疗后CRA、PCA的RI及眼压、MD明显低于滴眼组(P<0.05);汤液组治疗有效率明显高于滴眼组(P<0.05);汤液组和滴眼组不良反应率无差异(P>0.05)。结论:益精补阳还五汤联合马来酸噻吗洛尔滴眼液可有效改善POAG患者眼血供、眼压及视力、视野,提高了疗效,且安全性好。     

原发性开角型青光眼HRT视盘参数和视野缺损的关系

目的 :探讨原发性开角型青光眼视盘参数和视野平均缺损之间的关系。方法 :用海德堡视网膜断层扫描仪和自动视野计测定 5 5名原发性开角型青光眼患者的视盘参数 (杯盘面积比、盘沿面积、盘沿容积、视杯容积、视杯形态测量、视杯高度变异轮廓和平均神经纤维层厚度 )和静态光阈值。视盘参数与视野平均缺损作相关分析和多元线性回归分析。结果 :盘沿面积与平均缺损显著相关 (r =0 3 5 0 ,P <0 0 5 )。盘沿面积每减少 1mm2 ,视野缺损绝对值增加 8 0 81dB。本研究没有发现其它 6个参数与平均缺损相关关系的显著性。结论 :盘沿面积在HRT众多参数中最能反映青光眼的视野平均缺损程度。     

复明片联合马来酸噻吗洛尔滴眼液治疗开角型青光眼

目的：探讨复明片联合马来酸噻吗洛尔滴眼液治疗开角型青光眼的临床疗效。

方法：选择2017-04/2018-07于本院接受治疗的82例147眼开角型青光眼患者作为研究对象,根据治疗手段不同分为对照组41例72眼及观察组41例75眼。对照组予以马来酸噻吗洛尔滴眼液进行治疗,观察组在对照组基础上予以复明片治疗。观察两组患者临床疗效,对治疗前后眼压、血液流变学进行比较分析。

结果：治疗12wk后,观察组与对照组间的临床总有效率(94.7% vs 80.6%)比较有差异(P<0.05); 两组患者眼压均明显低于治疗6wk后及治疗前(P<0.05),且观察组眼压显著低于对照组(P<0.05); 对照组PSV、EDV及RI与治疗前无差异(P>0.05); 观察组PSV、EDV显著高于治疗前(P<0.05),而RI显著低于治疗前(P<0.05),且两组PSV、EDV及RI比较有差异(P<0.05)。两组患者总不良反应发生率比较无差异(P>0.05)。

结论：复明片联合马来酸噻吗洛尔滴眼液可有效改善患者的临床疗效,降眼压作用显著,同时对患者眼部血液流变学改善效果良好,安全可靠。     

益精补阳还五汤辅治开角型青光眼对其眼压及预后的影响

目的：研究益精补阳还五汤辅治开角型青光眼患者对其眼压控制及预后影响效果。

方法：选取我院2015-07/2017-07收治的开角型青光眼患者93例186眼。按照随机数字表法将所有患者分为两组。观察组47例94眼,给予马来酸噻吗洛尔滴眼液结合益精补阳还五汤辅助治疗; 对照组46例92眼,仅使用马来酸噻吗洛尔滴眼液治疗。观察比较两组患者治疗后临床疗效,治疗前后视力、眼压、视网膜中央动脉血流测定值、平均缺损范围、视野平均光敏度以及图像诱发视觉电位情况。

结果：观察组治疗后总有效率明显高于对照组(85.1% vs 63.0%)(P<0.01)。治疗后,观察组眼压明显低于对照组(P<0.01)。观察组治疗后视网膜中央动脉血流RI测定值明显低于对照组(P<0.01),PSA、EDV测定值明显高于对照组(P=0.011、<0.01)。观察组治疗后视野平均光敏度明显高于对照组(P=0.001),平均缺损范围明显少于对照组(P=0.011)。

结论：使用益精补阳还五汤辅治开角型青光眼临床疗效显著,可有效控制患者眼压水平,扩大视野范围,促进血流循环,改善预后。     

Disc and field damage in patients with unilateral visual field loss from primary open-angle glaucoma

To assess the temporal relationship between field and disc change in early glaucoma, 24 patients with unilateral visual field loss from primary open angle glaucoma were identified for planimetric optic disc measurements. Cross-sectional analysis of disc rim area was performed and compared to 25 age-matched normal controls. The mean (±SD) disc rim area in eyes with normal visual fields (1.10 ± 0.31 mm²) was slightly larger than that of eyes with visual field loss (0.90 ± 0.33 mm²). The mean disc rim area in the control group (1.49 ± 0.19 mm²) was significantly different from both sets of eyes in the asymmetric primary open angle glaucoma patients (p = 0.000). These findings support the hypothesis that loss of the optic disc rim can be detected before perimetric abnormalities develop in patients with glaucoma.     

拉坦前列腺素与溴莫尼定治疗开角型青光眼的疗效对比

目的：：对比评价拉坦前列腺素和溴莫尼定在开角型青光眼中的有效性和安全性,为临床合理用药提供参考。方法：选择121例136眼原发性开角型青光眼患者为研究对象,按照治疗药物的不同随机分为试验组62例70眼和对照组59例66眼。对照组患者溴莫尼定滴眼液2次/d,试验组患者拉坦前列腺素滴眼液1次/d,随访3mo,定期检查两组患者的眼压、视力、用药不良反应等。结果：治疗12 wk 后,对照组患者的眼压为18.1±1.3mmHg,试验组为17.0±0.9mmHg,均比治疗前降低( P<0.05),试验组患者的眼压波动明显小于对照组;对照组治疗前后的LogMAR视力差异性小,试验组治疗后有显著性提高;对照组出现充血、灼烧感、流泪、眼睑水肿等不良反应,试验组不良反应小。结论：拉坦前列腺素可以明显降低青光眼患者的眼压,降低高眼压对患者视力的影响,且不良反应少,值得临床推广应用。     

Optic nerve damage in highly myopic eyes with chronic open-angle glaucoma

PURPOSE: To compare the amount of optic nerve damage in relation to intraocular pressure in highly myopic eyes with chronic open-angle glaucoma versus non-highly myopic eyes with chronic open-angle glaucoma. METHODS: The comparative clinical observational study included 1841 eyes of 1100 patients with chronic open-angle glaucoma. The highly myopic study group consisted of 25 eyes with a myopic refractive error equal to or higher than -8 diopters. It was subdivided into eyes with an optic disc size larger than 2.7 mm2 and eyes with an optic disc smaller than 2.7 mm2. The control group included the remaining, non-highly myopic eyes (n=1816). For all patients, a morphometric analysis of color stereo optic disc photographs was performed. Main outcome measures were morphometric optic disc measurements and intraocular pressure. RESULTS: In the highly myopic, large-optic-disc study group compared with the control group, maximal and minimal intraocular pressure readings were significantly (p<0.05) lower and neuroretinal rim area corrected for optic disc size was slightly (p=0.16) smaller. Comparing the total highly myopic study group with a control group adjusted for optic disc area, neuroretinal rim area was significantly (p=0.039) smaller in the study group with no significant difference in intraocular pressure measurements between the groups. CONCLUSIONS: At a given intraocular pressure in chronic open-angle glaucoma, optic nerve damage may be more pronounced in highly myopic eyes with large optic discs than in non-highly myopic eyes. This may suggest a higher susceptibility for glaucomatous optic nerve fiber loss in highly myopic eyes than in non-highly myopic eyes.     

Morphology of the optic papilla in glaucoma. II. Secondary chronic open angle glaucoma

Previous studies have shown that the chronic open-angle glaucomas form a heterogeneous spectrum of diseases which have in common an open anterior chamber angle and glaucomatous optic nerve damage. Purpose of this study was to evaluate whether the appearance of the optic disc shows specific features among various types of secondary chronic open-angle glaucoma. METHODS: Clinical data and color-stereo optic disc photographs of 126 patients with pseudoexfoliative glaucoma and 47 patients with pigmentary glaucoma were compared with those of 501 patients with primary open-angle glaucoma (POAG) and of 481 normal subjects. The glaucoma groups did not differ in neuroretinal rim nor in perimetric mean defect. RESULTS: Mean optic disc area was significantly smaller in the pseudoexfoliative glaucoma eyes (2.54 +/- 0.51 mm2 vs. 2.71 +/- 0.63 mm2, p = 0.03) than in the primary open-angle glaucoma eyes. The pigmentary glaucoma group did not vary significantly from the primary open-angle glaucoma group in size of the optic disc. No significant differences were found for neuroretinal rim area, configuration of neuroretinal rim, depth of optic cup and diameters of the retinal arterioles and venules at the disc border between the secondary glaucoma groups and the POAG group respectively. Size of zone beta of the parapapillary atrophy was slightly, but not significantly smaller in the secondary glaucoma groups than in POAG. In the secondary glaucoma groups, the maximal intraocular pressure measurements were significantly (p < 0.001) higher than in the group with POAG. All glaucoma groups had a significantly smaller neuroretinal rim, significantly smaller retinal arterioles, and significantly larger parapapillary atrophy compared to the normal group. CONCLUSIONS: Except of a slightly smaller optic disc in eyes with pseudoexfoliative glaucoma, eyes with secondary glaucoma due to pseudoexfoliation or due to pigmentary dispersion do not vary significantly in their optic disc morphology compared to POAG and do not show pathognomonic features of the optic disc despite marked changes in the anterior segment of the eye.     

正常眼压性青光眼患者视盘区血管密度与视野指数和视野损伤形态的关系

目的：研究正常眼压性青光眼(NTG)视盘区血管密度变化与青光眼视野指数(VFI)和视野损伤形态分期的关系。

方法：选取我院2018-12/2020-12 NTG患者106例106眼和原发性开角型青光眼(POAG)患者79例79眼进行横断面研究,其中双眼病变者采用随机数字表选取1眼为样本,同时选取我院健康体检者92名为对照组,三组均完成视盘血管密度、VFI检测和视野缺损形态分期,然后分析视盘血管密度与VFI和视野缺损形态分期的关系。

结果：POAG组眼压明显高于NTG组和对照组(P<0.05); NTG组和POAG组视盘区全区域血管密度、大血管密度和毛细血管密度均明显低于对照组(P<0.05),无血管区密度均明显高于对照组(P<0.05),且NTG组和POAG组各项指标比较有差异(P<0.05); NTG组和POAG组VFI均明显低于对照组(P<0.05),视野平均缺损(MD)明显高于对照组(P<0.05),且NTG组和POAG组VFI和MD比较无差异(P>0.05); 随着视野缺损形态分期增加,NTG患者视盘全区域血管密度和毛细血管密度呈明显降低趋势(P<0.05); NTG患者视盘全区域血管密度和毛细血管密度与VFI呈正相关性,与视野缺损形态分期呈负相关性,无血管区密度与VFI呈负相关性,与视野缺损形态分期呈正相关性(均P<0.05)。

结论：NTG患者视盘血管密度较POAG患者和正常人群明显降低,且与VFI和视野缺损形态分期存在明显相关性,其中以毛细血管密度相关程度最高,可见OCTA对NTG诊断、治疗和随访均具有重要临床意义。     

Inter-eye differences in chronic open-angle glaucoma patients with unilateral disc hemorrhages

OBJECTIVE: Flame-shaped optic disc hemorrhages are a hallmark of glaucomatous optic neuropathy. The purpose of this study was to evaluate which parameters differ between companion eyes with and without an optic disc hemorrhage in patients with chronic open-angle glaucoma. DESIGN: Comparative (companion eye) observational case series. PATIENTS: The study included 99 white patients with bilateral chronic open-angle glaucoma and unilateral flame-shaped optic disc hemorrhages. METHODS: All patients underwent qualitative and morphometric evaluation of color stereo optic disc photographs. MAIN OUTCOME MEASURES: Size and shape of the optic disc, neuroretinal rim and parapapillary atrophy, diameter of the retinal vessels, intraocular pressure measurements, and both mean value and loss variance value of the visual field examination. RESULTS: In an intraindividual inter-eye comparison, the eyes with disc hemorrhages and the contralateral eyes without disc bleeding did not vary significantly (P > 0.20) in size and shape of the optic disc and neuroretinal rim, optic cup depth, size of alpha and beta zone of parapapillary atrophy, retinal vessel diameter, intraocular pressure measurements, refractive error, and perimetric indices. CONCLUSIONS: In bilateral chronic open-angle glaucoma, the development of unilateral optic disc hemorrhages does not depend on inter-eye differences in size and shape of the optic disc, neuroretinal rim and parapapillary atrophy, diameter of the retinal vessels, intraocular pressure measurements, or visual field loss.