Visual Field Progression Pattern Associated With Optic Disc Tilt Morphology in Myopic Open-Angle Glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Optic Nerve Studies

Background:

• Myopic open-angle glaucoma (OAG) presents unique challenges in predicting visual field (VF) progression.
• Optic disc morphology, specifically tilt, may influence disease trajectory in myopic OAG.

Purpose of the Study:

• To investigate the long-term visual field (VF) progression patterns in myopic open-angle glaucoma (OAG) based on optic disc tilt morphology.
• To compare VF progression between myopic OAG with temporally tilted discs, inferiorly tilted discs, and nonmyopic OAG.

Main Methods:

• A retrospective, comparative, longitudinal cohort study.
• Myopic OAG eyes were categorized into temporally tilted and inferiorly tilted disc groups.
• Kaplan-Meier survival analysis and Cox proportional hazards modeling were used to assess progression rates and risk factors.

Main Results:

• Myopic OAG with inferiorly tilted discs exhibited more rapid VF progression and higher rates of hemifield involvement compared to temporally tilted discs and nonmyopic OAG.
• Predictors of progression included more medications, earlier VF defects, and an inferiorly tilted disc.
• In the inferiorly tilted disc group, progression was associated with younger age and earlier baseline VF defects.

Conclusions:

• Optic disc tilt morphology is significantly associated with VF progression in myopic OAG.
• In OAG with inferiorly tilted discs, VF progression may eventually stabilize after affecting areas related to the optic disc tilt.