Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin

Jonathan C. Chou; Clara C. Cousins; John B. Miller; Brian J. Song; Lucy Q. Shen; Michael A. Kass; Janey L. Wiggs; Louis R. Pasquale

doi:10.1016/j.ajo.2017.12.024

Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin

Jonathan C. Chou, Clara C. Cousins, John B. Miller, Brian J. Song, Lucy Q. Shen, Michael A. Kass, Janey L. Wiggs, Louis R. Pasquale

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Purpose: To analyze optic disc hemorrhages (DH) associated with primary open-angle glaucoma by quantifying their geometric profile and comparing their densitometry with hemorrhages from retinal vein occlusions (RVO) and retinal macroaneurysms (MA), which have venous and arterial sources of bleeding, respectively. Design: Retrospective cross-sectional study. Methods: SETTING: Massachusetts Eye & Ear. POPULATION: Fundus images of DH (n = 40), MA (n = 14), and RVO (n = 25) were identified. Patient clinical backgrounds and demographics were obtained. MAIN OUTCOME MEASURES: Grayscale pixel intensity units of hemorrhages and adjacent arteriole and venule over the same background tissue were measured. Densitometry differentials (arteriole or venule minus hemorrhage [ΔA and ΔV, respectively]) were calculated. The ratios of length (radial) to midpoint width for DH were calculated. Mean ΔA and ΔV between groups were compared with t tests. Multiple linear regression assessed the relation of retinal hemorrhage diagnosis to ΔA and ΔV and of DH shape to ΔA and ΔV. Results: Mean (± standard deviation) ΔA and ΔV for DH (6.9 ± 7.1 and −4.7 ± 8.0 pixel intensity units, respectively) and MA (5.3 ± 5.9 and −6.0 ± 4.6, respectively) were comparable (P ≥.43). Mean ΔA (14.6 ± 7.7) and ΔV (6.4 ± 6.3) for RVO were significantly higher compared to DH and MA (P <.0001) and remained significant in multivariable analyses. A unit increase in DH length-to-width ratio was associated with 1.2 (0.5) and 1.3 (0.5) pixel intensity unit (standard error) decrease in ΔA and ΔV, respectively (P ≤.014). Conclusions: DH have densitometry profiles comparable to MA and different from RVO, suggesting that DH in glaucoma have an arterial origin.

Original language	English
Pages (from-to)	108-116
Number of pages	9
Journal	American journal of ophthalmology
Volume	187
DOIs	https://doi.org/10.1016/j.ajo.2017.12.024
State	Published - Mar 2018

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@article{f1ea5d51c689496a97b4cc727bac0a24,

title = "Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin",

abstract = "Purpose: To analyze optic disc hemorrhages (DH) associated with primary open-angle glaucoma by quantifying their geometric profile and comparing their densitometry with hemorrhages from retinal vein occlusions (RVO) and retinal macroaneurysms (MA), which have venous and arterial sources of bleeding, respectively. Design: Retrospective cross-sectional study. Methods: SETTING: Massachusetts Eye & Ear. POPULATION: Fundus images of DH (n = 40), MA (n = 14), and RVO (n = 25) were identified. Patient clinical backgrounds and demographics were obtained. MAIN OUTCOME MEASURES: Grayscale pixel intensity units of hemorrhages and adjacent arteriole and venule over the same background tissue were measured. Densitometry differentials (arteriole or venule minus hemorrhage [ΔA and ΔV, respectively]) were calculated. The ratios of length (radial) to midpoint width for DH were calculated. Mean ΔA and ΔV between groups were compared with t tests. Multiple linear regression assessed the relation of retinal hemorrhage diagnosis to ΔA and ΔV and of DH shape to ΔA and ΔV. Results: Mean (± standard deviation) ΔA and ΔV for DH (6.9 ± 7.1 and −4.7 ± 8.0 pixel intensity units, respectively) and MA (5.3 ± 5.9 and −6.0 ± 4.6, respectively) were comparable (P ≥.43). Mean ΔA (14.6 ± 7.7) and ΔV (6.4 ± 6.3) for RVO were significantly higher compared to DH and MA (P <.0001) and remained significant in multivariable analyses. A unit increase in DH length-to-width ratio was associated with 1.2 (0.5) and 1.3 (0.5) pixel intensity unit (standard error) decrease in ΔA and ΔV, respectively (P ≤.014). Conclusions: DH have densitometry profiles comparable to MA and different from RVO, suggesting that DH in glaucoma have an arterial origin.",

author = "Chou, {Jonathan C.} and Cousins, {Clara C.} and Miller, {John B.} and Song, {Brian J.} and Shen, {Lucy Q.} and Kass, {Michael A.} and Wiggs, {Janey L.} and Pasquale, {Louis R.}",

note = "Funding Information: Jonathan Chou, MD, is an Ophthalmology resident from Massachusetts Eye and Ear. Dr. Chou graduated summa cum laude from Northwestern University with a BS in Communication Sciences. He received his MD from Northwestern University, Feinberg School of Medicine, where he earned membership in the Alpha Omega Alpha honor society. He is the recipient of several awards, including a Research to Prevent Blindness Fellowship and an Illinois Society for the Prevention of Blindness Research Grant. Clara Cousins is a research assistant affiliated with Massachusetts Eye and Ear and a student in Chemical and Physical Biology at Harvard University. Her research interests include vascular biology and imaging. She received research scholarships from Massachusetts General Hospital and Harvard University and the Detur Prize from Harvard. Supplemental Material Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",

year = "2018",

month = mar,

doi = "10.1016/j.ajo.2017.12.024",

language = "English",

volume = "187",

pages = "108--116",

journal = "American journal of ophthalmology",

issn = "0002-9394",

}

TY - JOUR

T1 - Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin

AU - Chou, Jonathan C.

AU - Cousins, Clara C.

AU - Miller, John B.

AU - Song, Brian J.

AU - Shen, Lucy Q.

AU - Kass, Michael A.

AU - Wiggs, Janey L.

AU - Pasquale, Louis R.

N1 - Funding Information: Jonathan Chou, MD, is an Ophthalmology resident from Massachusetts Eye and Ear. Dr. Chou graduated summa cum laude from Northwestern University with a BS in Communication Sciences. He received his MD from Northwestern University, Feinberg School of Medicine, where he earned membership in the Alpha Omega Alpha honor society. He is the recipient of several awards, including a Research to Prevent Blindness Fellowship and an Illinois Society for the Prevention of Blindness Research Grant. Clara Cousins is a research assistant affiliated with Massachusetts Eye and Ear and a student in Chemical and Physical Biology at Harvard University. Her research interests include vascular biology and imaging. She received research scholarships from Massachusetts General Hospital and Harvard University and the Detur Prize from Harvard. Supplemental Material Publisher Copyright: © 2018 Elsevier Inc.

PY - 2018/3

Y1 - 2018/3

N2 - Purpose: To analyze optic disc hemorrhages (DH) associated with primary open-angle glaucoma by quantifying their geometric profile and comparing their densitometry with hemorrhages from retinal vein occlusions (RVO) and retinal macroaneurysms (MA), which have venous and arterial sources of bleeding, respectively. Design: Retrospective cross-sectional study. Methods: SETTING: Massachusetts Eye & Ear. POPULATION: Fundus images of DH (n = 40), MA (n = 14), and RVO (n = 25) were identified. Patient clinical backgrounds and demographics were obtained. MAIN OUTCOME MEASURES: Grayscale pixel intensity units of hemorrhages and adjacent arteriole and venule over the same background tissue were measured. Densitometry differentials (arteriole or venule minus hemorrhage [ΔA and ΔV, respectively]) were calculated. The ratios of length (radial) to midpoint width for DH were calculated. Mean ΔA and ΔV between groups were compared with t tests. Multiple linear regression assessed the relation of retinal hemorrhage diagnosis to ΔA and ΔV and of DH shape to ΔA and ΔV. Results: Mean (± standard deviation) ΔA and ΔV for DH (6.9 ± 7.1 and −4.7 ± 8.0 pixel intensity units, respectively) and MA (5.3 ± 5.9 and −6.0 ± 4.6, respectively) were comparable (P ≥.43). Mean ΔA (14.6 ± 7.7) and ΔV (6.4 ± 6.3) for RVO were significantly higher compared to DH and MA (P <.0001) and remained significant in multivariable analyses. A unit increase in DH length-to-width ratio was associated with 1.2 (0.5) and 1.3 (0.5) pixel intensity unit (standard error) decrease in ΔA and ΔV, respectively (P ≤.014). Conclusions: DH have densitometry profiles comparable to MA and different from RVO, suggesting that DH in glaucoma have an arterial origin.

AB - Purpose: To analyze optic disc hemorrhages (DH) associated with primary open-angle glaucoma by quantifying their geometric profile and comparing their densitometry with hemorrhages from retinal vein occlusions (RVO) and retinal macroaneurysms (MA), which have venous and arterial sources of bleeding, respectively. Design: Retrospective cross-sectional study. Methods: SETTING: Massachusetts Eye & Ear. POPULATION: Fundus images of DH (n = 40), MA (n = 14), and RVO (n = 25) were identified. Patient clinical backgrounds and demographics were obtained. MAIN OUTCOME MEASURES: Grayscale pixel intensity units of hemorrhages and adjacent arteriole and venule over the same background tissue were measured. Densitometry differentials (arteriole or venule minus hemorrhage [ΔA and ΔV, respectively]) were calculated. The ratios of length (radial) to midpoint width for DH were calculated. Mean ΔA and ΔV between groups were compared with t tests. Multiple linear regression assessed the relation of retinal hemorrhage diagnosis to ΔA and ΔV and of DH shape to ΔA and ΔV. Results: Mean (± standard deviation) ΔA and ΔV for DH (6.9 ± 7.1 and −4.7 ± 8.0 pixel intensity units, respectively) and MA (5.3 ± 5.9 and −6.0 ± 4.6, respectively) were comparable (P ≥.43). Mean ΔA (14.6 ± 7.7) and ΔV (6.4 ± 6.3) for RVO were significantly higher compared to DH and MA (P <.0001) and remained significant in multivariable analyses. A unit increase in DH length-to-width ratio was associated with 1.2 (0.5) and 1.3 (0.5) pixel intensity unit (standard error) decrease in ΔA and ΔV, respectively (P ≤.014). Conclusions: DH have densitometry profiles comparable to MA and different from RVO, suggesting that DH in glaucoma have an arterial origin.

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U2 - 10.1016/j.ajo.2017.12.024

DO - 10.1016/j.ajo.2017.12.024

M3 - Article

C2 - 29330062

AN - SCOPUS:85041381749

SN - 0002-9394

VL - 187

SP - 108

EP - 116

JO - American journal of ophthalmology

JF - American journal of ophthalmology

ER -

Fundus Densitometry Findings Suggest Optic Disc Hemorrhages in Primary Open-Angle Glaucoma Have an Arterial Origin

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