Longitudinal Evaluation of the Structural and Functional Changes Associated with Glaucoma in Myopia

Area of Science:

• Ophthalmology
• Glaucoma Research
• Myopia Studies

Background:

• Primary open angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Myopia is increasingly prevalent and its role in glaucoma progression requires further investigation.
• Understanding factors influencing glaucoma progression is crucial for timely intervention.

Purpose of the Study:

• To estimate the rate of change in retinal nerve fiber layer (RNFL) thickness in glaucoma patients.
• To assess the rate of visual field progression in glaucoma patients.
• To compare these progression rates between myopic and non-myopic glaucoma patients.

Main Methods:

• A prospective, observational cohort study involving 245 eyes of 135 glaucoma patients.
• Follow-up duration averaged 6.08 years with regular RNFL imaging and visual field testing every 4 months.
• Data analysis adjusted for age, axial length, intraocular pressure (IOP), and baseline RNFL thickness.

Main Results:

• While axial length as a continuous variable showed no association with progression, high myopia (axial length ≥26.5 mm) was linked to faster RNFL thinning and visual field reduction.
• Myopic eyes with axial lengths ≥26.5 mm exhibited an average RNFL thickness change rate of 0.16 μm/y faster.
• These myopic eyes also showed a 0.21%/y faster rate of visual field index reduction.

Conclusions:

• High myopia, specifically axial lengths ≥26.5 mm, is associated with accelerated progression in both RNFL thickness and visual field in primary open angle glaucoma.
• These findings suggest myopia is a risk factor for POAG progression.
• Incorporating axial length measurements into clinical decision-making for myopic POAG patients may be beneficial.