Macular Optical Coherence Tomography Parameters and Incident Glaucoma Among Myopic Eyes

The purpose of this study was to estimate the correlations between macular optical coherence tomography (OCT)-derived metrics and incident glaucoma risk in myopic eyes.

This longitudinal observational study included 24,181 individuals with myopia (spherical equivalence [SE] ≤ -0.5 diopters [D]) from the UK Biobank study.

Participants (mean age = 55.5 ± 8.0 years, 54.5% women) were followed up for 13.2 ± 1.2 years and incident glaucoma was diagnosed in 582 eyes. Those who developed glaucoma were significantly older (P < 0.001), more likely to be male participants (P < 0.001), and had more pronounced myopic refractive error (P < 0.001). Cox regression analyses indicated that participants with thinner retinal nerve fiber layer (RNFL; hazard ratio [HR] = 0.97, 95% confidence interval [CI] = 0.96-0.99, P < 0.001), thinner ganglion cell-inner plexiform layer (GCIPL; HR = 0.97, 95% CI = 0.96-0.98, P < 0.001), and thinner ganglion cell complex (GCC; HR = 0.98, 95% CI = 0.97-0.99, P < 0.001) had an increasing risk of incident glaucoma after adjustment for age, sex, ethnic group, and SE. Meanwhile, the thicker inner nuclear layer (INL; HR = 1.03, 95% CI = 1.01-1.05, P = 0.002) and photoreceptor segments (PS; HR = 1.03, 95% CI = 1.01-1.06, P = 0.024) were positive for the incidence of glaucoma.

This longitudinal study suggested that baseline RNFL, GCIPL, GCC, INL, and PS thickness were significant predictors for the incidence of glaucoma among myopic participants, which indicated a pattern of internal layer thinning (except INL) and outer layer thickening in these pre-glaucoma participants.

Our study highlighted the potential of OCT-derived indicators for early glaucoma risk assessment and clinical monitoring.