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      Relationship between optic disc hemorrhage and glaucoma among patients diagnosed with systemic hypertension and Diabetes Mellitus: the Colombian Glaucoma Study Translated title: Relación entre Hemorragia de Disco Óptico y Glaucoma en pacientes con diagnóstico de Hipertensión Sistémica y Diabetes Mellitus: Estudio Colombiano de Glaucoma

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          Abstract

          Abstract 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.

          Translated abstract

          Resumen 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.

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          Most cited references19

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          The pathophysiology and treatment of glaucoma: a review.

          Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries.
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            The definition and classification of glaucoma in prevalence surveys.

            This review describes a scheme for diagnosis of glaucoma in population based prevalence surveys. Cases are diagnosed on the grounds of both structural and functional evidence of glaucomatous optic neuropathy. The scheme also makes provision for diagnosing glaucoma in eyes with severe visual loss where formal field testing is impractical, and for blind eyes in which the optic disc cannot be seen because of media opacities.
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              An evidence-based review of prognostic factors for glaucomatous visual field progression.

              To examine which prognostic factors are associated with glaucomatous visual field progression.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2022
                : 4
                : 4
                : 220-228
                Affiliations
                [10] Cali orgnameCollective Innovations Colombia
                [19] orgnameMcWilliams Collective Estados Unidos de América
                [2] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [9] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [3] orgnameMcWilliams Collective Estados Unidos de América
                [21] San Antonio Texas orgnameUniversity of Tennessee Health Science Center Estados Unidos de América
                [7] Memphis Tennessee orgnameUniversity of Tennessee Health Science Center Estados Unidos de América
                [5] Cali orgnameCollective Innovations Colombia
                [13] Cali orgnameCollective Innovations Colombia
                [15] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [17] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [16] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [6] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [8] Cali orgnameCollective Innovations Colombia
                [11] Cali orgnameCollective Innovations Colombia
                [20] Cali orgnameGSR Medical Center Colombia
                [1] Cali orgnameCollective Innovations Colombia
                [14] San Antonio Texas orgnameUniversity of Texas Health Estados Unidos de América
                [18] Cali orgnameCollective Innovations Colombia
                [12] Cali Bogotá orgnamePontificia Universidad Javeriana Colombia
                [4] Cali orgnameGSR Medical Center Colombia
                Article
                S2695-50752022000400008 S2695-5075(22)00400400008
                10.53986/ibjm.2022.0040
                8648116e-9a0b-4d74-84cf-119b8ac94a6c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 August 2022
                : 25 September 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 9
                Product

                SciELO Spain

                Categories
                Original Article

                Intraocular pressure,Open angle glaucoma,Systemic hypertension,Glaucoma de ángulo abierto,Diabetes mellitus,Optic disc hemorrhage,Presión intraocular,Hipertensión sistémica,Hemorragia del disco óptico

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