PURPOSE: Parapapillary atrophy (PPA) and disc hemorrhage (DH) are associated with glaucoma. We sought to determine whether they are anatomically related. DESIGN: Retrospective study. METHODS: All digital optic nerve stereophotographs obtained over a one-year period were screened for the presence of DH. Only patients with DH were included. The location of the greatest beta zone PPA width as defined by the radial distance between the scleral rim and the outer border of the beta zone was compared in each patient. The clock hour location of the DH was determined. Baseline central corneal thickness, intraocular pressure, vertical cup-to-disc ratio, and visual field indices were obtained. RESULTS: Photographs from 1,559 glaucoma patients were evaluated and 46 eyes with unilateral DH were identified; 42 (91.3%) had beta zone PPA and 38 eyes had asymmetric PPA width. DH occurred more frequently in the eye with the greater PPA width (29/38 eyes [76.3%]; kappa = 0.611; P < .001). The DH fell on the point of greatest PPA width in 10 (23.9%) of 42 eyes (P < .05, Fisher exact test) and within two clock hours of the greatest PPA width in 31 (73.8%) of 42 eyes (P < .001, Chi-square test). Logistic regression analysis determined that greater PPA width (odds ratio, 17.16; 95% confidence interval, 5.34 to 55.12; P < .001) was the only ocular characteristic to predict the laterality of the DH. CONCLUSIONS: DHs tend to occur in the eye with the greatest PPA width and usually are found within the region of its greatest width.
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机译：目的：乳头旁萎缩（PPA）和椎间盘出血（DH）与青光眼有关。我们试图确定它们是否在解剖上相关。设计：回顾性研究。方法：筛选在一年内获得的所有数字视神经立体照片中是否存在DH。仅包括DH患者。比较每位患者的最大β区PPA宽度的位置，该宽度由巩膜边缘和β区外边界之间的径向距离定义。确定了DH的时钟时间位置。获得基线中心角膜厚度，眼内压，垂直杯碟比和视野指数。结果：对1,559例青光眼患者的照片进行了评估，确定了46只单侧DH眼。 42例（91.3％）的患者具有β区PPA，38眼的PPA宽度不对称。 DH在PPA宽度较大的眼中更常见（29/38眼[76.3％; kappa = 0.611; P <.001）。 DH落在42眼中的10只（23.9％）的最大PPA宽度上（P <.05，Fisher精确检验），并且在42眼中31例（73.8％）的最大PPA宽度的两个时钟小时内（P <.001，卡方检验）。 Logistic回归分析确定更大的PPA宽度（比值比为17.16; 95％的置信区间为5.34至55.12; P <0.001）是预测DH偏侧性的唯一眼部特征。结论：DHs倾向于以最大PPA宽度出现在眼睛中，通常在其最大宽度区域内发现。
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