Purpose: To determine the frequency of optic disk hemorrhages in the adult Chinese population.
Design: Population-based prevalence survey.
Methods: The study included 4439 subjects out of 5324 subjects invited to participate (response rate 83.4%) with an age of 40+ years. Mean age was 56.2 +/- 10.6 years. Color optic disk photographs (45 degrees) were morphometrically examined.
Results: Optic disk photographs were available for 8655 eyes of 4378/4439 (98.6%) subjects. Prevalence of disk hemorrhages was 107/8655 (1.24%; 95% confidence interval (CI): 1.00%, 1.47%) eyes. Occurrence of disk hemorrhages was significantly associated with glaucomatous optic nerve damage (P < .001; OR: 9.3; 95% CI: 5.6, 15.4) and age (P = .008; 95% CI: 1.01, 1.05). The occurrence of disk hemorrhages was not significantly associated with intraocular pressure (IOP) (P = .63; 95% CI: 0.97, 1.06), refractive error (P = .06; 5% CI: 0.87, 2.18), and visual field score (P = .81; 95% CI: 0.96, 1.03). Defining glaucoma as glaucomatous optic disk appearance, 20/107 (18.7%; 95% CI: 11.2%, 26.2%) disk hemorrhages were found in glaucomatous eyes. Out of 226 glaucomatous eyes, 20/226 (8.8%; 95%CI: 5.12%, 12.58%) eyes showed a disk hemorrhage. Hypertensive glaucoma eyes and normotensive glaucoma eyes did not vary considerably in frequency of disk hemorrhages (P = .44; OR: 1.82; 95% CI: 0.59, 5.68).
Conclusions: Disk hemorrhages occur in a frequency of approximately 1.2% in adult Chinese. Major associated factors are glaucomatous optic neuropathy and age. Presence of a disk hemorrhage suggested glaucomatous optic nerve damage with a positive predictive value of approximately 20%. About 9% of glaucomatous eyes showed a disk hemorrhage at the time of examination.