Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine
Original article

Relationship between Optic Disc Hemorrhage and Glaucoma among patients diagnosed with Systemic Hypertension and Diabetes Mellitus: The Colombian Glaucoma Study

Relación entre Hemorragia de Disco Óptico y Glaucoma en pacientes con diagnóstico de Hipertensión Sistémica y Diabetes Mellitus: Estudio Colombiano de Glaucoma

Carlos Eduardo Rivera, Maria Catalina Ferreria, Laura Libreros-Peña, M. Ahsan Shah, Juan Carlos Aristizaba, Edgar Muñoz, Catalina Gomez-Duarte, Beatriz Eugenia Ossa-Lopez, Gabriel Burbano-Montenegro, Ankur Seth

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Introduction: Glaucoma is a leading cause of irreversible blindness worldwide; several risk factors have been identified as major underlying causes for developing this condition. Optic disc hemorrhage has been identified as a risk factor for the development and progression of primary open-angle glaucoma, as well it has been related to playing an important role in normal-tension glaucoma.
Material and methods: A cross-sectional study was conducted in Colombia among hypertensive and diabetic patients. This study included 2,067 subjects older than 50 years who were attended by a group of ophthalmologists in six cities in Colombia who conducted a complete medical and ophthalmological examination and applied standardized questionnaires and interviews aiming to evaluate participant’s health conditions and lifestyles.
Results: We found a prevalence of Optic disc hemorrhage (ODH) of 0.4%. ODH presented an OR: 8.82 (95% CI 1.60 - 48.52) for the presence of Glaucoma. Patients diagnosed with systemic hypertension had an OR: 0.02 (95% CI 0.00 - 0.96); Patients with Retinal Nerve Fiber Layer Defect (RNFL) presented an OR: 509.40 (95% CI 8.60 - 30152.97) for the presence of ODH and 50% of patients with ODH did not have a diagnosis of glaucoma.
Conclusions: Despite the low prevalence of ODH in our study (0.4%), its presence is a High-risk factor for the presence of Glaucoma. RNFL defect is also highly related to ODH and the presence of Glaucoma.


Open angle glaucoma; Optic disc hemorrhage; Systemic hypertension; Diabetes mellitus; Intraocular pressure


Introducción: El glaucoma es una de las principales causas de ceguera irreversible a nivel mundial; varios factores de riesgo han sido identificados como las principales causas subyacentes para el desarrollo de esta condición. La hemorragia del disco óptico se ha identificado como un factor de riesgo para el desarrollo y progresión del glaucoma primario de ángulo abierto, así como también se ha relacionado con desempeñar un papel importante en el glaucoma de tensión normal.
Material y métodos: Se realizó un estudio transversal en Colombia entre pacientes hipertensos y diabéticos. Este estudio incluyó a 2.067 sujetos mayores de 50 años que fueron atendidos por un grupo de oftalmólogos en seis ciudades de Colombia, quienes realizaron un examen médico y oftalmológico completo y aplicaron cuestionarios y entrevistas estandarizados con el fin de evaluar las condiciones de salud y estilos de vida de los participantes.
Resultados: Encontramos una prevalencia de hemorragia del disco óptico (HDO) del 0,4%. ODH presentó un OR: 8,82 (IC 95% 1,60 - 48,52) para la presencia de Glaucoma. Los pacientes diagnosticados de hipertensión sistémica tuvieron OR: 0,02 (IC 95% 0,00 - 0,96); Los pacientes con Defecto de la Capa de Fibras Nerviosas de la Retina (RNFL) presentaron un OR: 509,40 (IC 95% 8,60 - 30152,97) para la presencia de ODH y el 50% de los pacientes con ODH no tenían diagnóstico de glaucoma.
Conclusiones: A pesar de la baja prevalencia de HDO en nuestro estudio (0,4%), su presencia es un factor de alto riesgo para la presencia de Glaucoma. El defecto de la RNFL también está muy relacionado con la ODH y la presencia de glaucoma.

Palabras clave

Glaucoma de ángulo abierto; Hemorragia del disco óptico; Hipertensión sistémica; Diabetes mellitus; Presión intraocular


1. Kang JM, Tanna AP. Glaucoma. Med Clin North Am. 2021;105(3):493-510. doi: 10.1016/j.mcna.2021.01.004.
2. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11. doi: 10.1001/jama.2014.3192.
3. Kim KE, Park KH. Optic disc hemorrhage in glaucoma: pathophysiology and prognostic significance. Curr Opin Ophthalmol. 2017;28(2):105-12. doi: 10.1097/ICU.0000000000000345.
4. Kurvinen L, Harju M, Saari J, Vesti E. Altered temporal peripapillary retinal flow in patients with disc hemorrhages. Graefes Arch Clin Exp Ophthalmol. 2010;248(12):1771-5. doi: 10.1007/s00417-010-1441-7.
5. Patel HY, Buys YM, Trope GE. Nailfold capillaroscopy assessment in patients with glaucoma with a current optic disc hemorrhage. Can J Ophthalmol. 2015;50(2):155-8. doi: 10.1016/j.jcjo.2014.11.013.
6. Suh MH, Park KH. Pathogenesis and clinical implications of optic disk hemorrhage in glaucoma. Surv Ophthalmol. 2014;59(1):19-29. doi: 10.1016/j.survophthal.2013.03.005.
7. Wilde C, Poostchi A, Narendran R, MacNab HK, Hillman JG, Alexander P, et al. Prevalence of optic disc haemorrhages in an elderly UK Caucasian population and possible association with reticular pseudodrusen-the Bridlington Eye Assessment Project (BEAP): a cross-sectional study (2002-2006). Eye (Lond). 2019;33(4):580-6. doi: 10.1038/s41433-018-0263-4.
8. Rivera CE, Cantor E, Castillo A, Martinez A, Newball L, Rueda JC, et al. Prevalence of Primary Open Angle Glaucoma among Patients with Diagnosis of Systemic Hypertension and Diabetes Mellitus: The Colombian Glaucoma Study. Open J Ophthalmol. 2020;10(02):99–114. doi: 10.4236/ojoph.2020.102012.
9. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219. doi: 10.1093/eurheartj/eht151.
10. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002;86(2):238-42. doi: 10.1136/bjo.86.2.238.
11. Colombian Government. Census 2005. Available from: https://www.dane.gov.co/index.php/en/statistics-by-topic-1/population-and-demography/census-2005 (accessed August 2022).
12. Ishida K, Yamamoto T, Sugiyama K, Kitazawa Y. Disk hemorrhage is a significantly negative prognostic factor in normal-tension glaucoma. Am J Ophthalmol. 2000;129(6):707-14. doi: 10.1016/s0002-9394(00)00441-4.
13. De Moraes CG, Prata TS, Liebmann CA, Tello C, Ritch R, Liebmann JM. Spatially consistent, localized visual field loss before and after disc hemorrhage. Invest Ophthalmol Vis Sci. 2009;50(10):4727-33. doi: 10.1167/iovs.09-3446.
14. Ernest PJ, Schouten JS, Beckers HJ, Hendrikse F, Prins MH, Webers CA. An evidence-based review of prognostic factors for glaucomatous visual field progression. Ophthalmology. 2013;120(3):512-9. doi: 10.1016/j.ophtha.2012.09.005.
15. Klein R, Klein BE, Linton KL, De Mets DL. The Beaver Dam Eye Study: visual acuity. Ophthalmology. 1991;98(8):1310-5. doi: 10.1016/s0161-6420(91)32137-7.
16. Ong LS, Mitchell P, Healey PR, Cumming RG. Asymmetry in optic disc parameters: the Blue Mountains Eye Study. Invest Ophthalmol Vis Sci. 1999;40(5):849-57.
17. Furlanetto RL, De Moraes CG, Teng CC, Liebmann JM, Greenfield DS, Gardiner SK, et al. Risk factors for optic disc hemorrhage in the low-pressure glaucoma treatment study. Am J Ophthalmol. 2014;157(5):945-52. doi: 10.1016/j.ajo.2014.02.009.
18. World Health Organization (WHO). WHO launches first World report on vision. Available from: https://www.who.int/es/news/item/08-10-2019-who-launches-first-world-report-on-vision (accessed August 2022).
19. Ministry of Health and Social Protection Directorate of Epidemiology and Demography. Mortality in Colombia period 2020-2021. Available from:
https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/mortalidad-colombia-periodo-2020-2021.pdf(accessed August 2022).

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