Optic nerve head drusen and visual field loss in normotensive and hypertensive eyes |
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Authors: | Grippo Tomas M Shihadeh Wisam A Schargus Marc Gramer Eugen Tello Celso Liebmann Jeffrey M Ritch Robert |
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Affiliation: | Einhorn Clinical Research Center, The New York Eye and Ear Infirmary, New York, USA. |
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Abstract: | OBJECTIVE: To compare visual field loss (VFL) in eyes with optic nerve head drusen (ONHD) with or without ocular hypertension (OHT). METHODS: The records of all patients aged 45 years or older with a diagnosis of ONHD at 2 centers were reviewed. OHT was defined as intraocular pressure >or=22 mm Hg. We categorized ONHD into 3 grades based on visibility on disc photographs. RESULTS: We identified 22 eyes (13 patients) with both ONHD and OHT and 81 normotensive eyes (47 patients) with ONHD. VFL was present in 20/22 (90.9%) of hypertensive eyes compared with 54/81 (66.7%) of normotensive eyes (P=0.03, Fisher exact test). Drusen grade III and OHT were both independently and significantly associated with greater incidence of VFL (logistic regression analysis). CONCLUSIONS: VFL occurs more frequently in eyes with ONHD that also have OHT. Eyes with grade III ONHD are at increased risk for VFL compared to eyes with grade I drusen with the same intraocular pressure status. Patients with OHT and ONHD should undergo close surveillance for disease progression and be treated appropriately to prevent additional VFL. |
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