Disc hemorrhages and their risk factors in an urban South Korean population

Purpose. The aim of this study was to estimate the prevalence of disc hemorrhage (DH) and evaluate its related risk factors in an urban South Korean population. Methods. This retrospective cross-sectional study included subjects who underwent health screening at the Health Screening Center of Kangbuk Samsung Hospital from August 2012 to July 2013. All fundus photographs were first reviewed by two ophthalmologists and then by two glaucoma specialists and one retina specialist to determine the presence of DHs. In addition to fundus photographs, each participant completed systemic examination as well as sociodemographic and behavioral questionnaires. Results. Fundus photographs were available for 164,029/168,044 (97.61%) subjects 20 years and older. The prevalence of DH was 226/164,029 (0.14%; 95% confidence interval, 0.12 to 0.16) per subject. A large proportion (61.5%) of eyes with DH had localized wedge-shaped retinal nerve fiber layer defects indicative of glaucoma. There was also a slight increase in DH prevalence with age, but no other statistically significant associations were found. Conclusions. The prevalence of DH was 0.14% in urban South Korean subjects 20 years and older. Older age and the presence of glaucomatous retinal nerve fiber layer defects were associated with higher prevalence of DH. These findings suggest that the presence of a DH in an eye implies a high likelihood of glaucoma, although its absence does not indicate that glaucoma is absent.