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OBJECTIVES: To determine the positive predictive value (PPV) of disc haemorrhages (DHs) for the diagnosis of open angle glaucoma (OAG). METHODS: A retrospective review of 618 consecutive new referrals by community optometrists to a hospital glaucoma service, including 54 patients with DHs. All patients had a comprehensive eye examination. The primary outcome was whether the patient was diagnosed with OAG in either eye, with a secondary outcome of whether they were discharged at the first visit (first visit discharge rate, FVDR). RESULTS: 54 of 618 patients (8.7%) had a DH noted at the time of referral, including 21 referred with DH alone. 29 patients with DHs were diagnosed with OAG for a PPV of 54% (95% CI 40–67%), falling to 24% (95% CI 8–47%) in those with DH alone. The overall FVDR was 35%, increasing to 57% in those referred due to DH alone. The FVDR for those referred with DH alone was significantly higher than the FDVR of 25% among the 564 patients referred with suspected glaucoma without a DH (P = 0.001). The FVDR decreased to 35% for patients with a DH plus one other feature of glaucoma and to 0% for patients with a DH and at least two other features suggestive of glaucoma. CONCLUSIONS: Almost 60% of patients referred due to isolated DHs were discharged at the first visit to the glaucoma clinic, however almost one in four was diagnosed with OAG. Patients with DH and other features suggestive of glaucoma had a higher probability of glaucoma diagnosis.

Background To assess the effect of switching patients previously incompletely treated with ranibizumab (RBZ) to aflibercept (AFL) using a pro re nata (PRN) treatment strategy in neovascular age-related macular degeneration (nvAMD). Methods A retrospective case series was conducted on patients who had persistent or recurrent intra- and/or sub-retinal fluid treated initially with RBZ and subsequently switched to AFL. The main outcome measures were best corrected visual acuity (BCVA) and central retinal thickness (CRT) measured at different stages of the study. Friedman analysis of variance and Wilcoxon test were used to examine differences in BCVA and CRT. Results Two hundred and seven eyes from 182 patients were included. BCVA and CRT improved significantly initially following 3 RBZ injections with a mean gain of 3.7 letters (p