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. 2017 Apr 4:11:599-604.
doi: 10.2147/OPTH.S131370. eCollection 2017.

Is high myopia a risk factor for visual field progression or disk hemorrhage in primary open-angle glaucoma?

Koji Nitta  1 , Kazuhisa Sugiyama  2 , Ryotaro Wajima  1 , Gaku Tachibana  1
Affiliations

Is high myopia a risk factor for visual field progression or disk hemorrhage in primary open-angle glaucoma?

Koji Nitta et al. Clin Ophthalmol. .

Abstract

Purpose: The purpose of this study was to clarify differences between highly myopic and non-myopic primary open-angle glaucoma (POAG) patients, including normal-tension glaucoma patients.

Patients and methods: A total of 269 POAG patients were divided into two groups: patients with ≥26.5 mm of axial length (highly myopic group) and patients with <24.0 mm of axial length (non-myopic group).

Results: We analyzed 53 highly myopic and 93 non-myopic POAG patients. Age at first visit of the highly myopic group was significantly less than that of the non-myopic group (P<0.0001). Baseline intraocular pressures (IOPs) showed no significant differences. Follow-up IOPs of the non-myopic group were significantly lower than those of the highly myopic group (P=0.0009). According to the mean deviation definition of progression, the cumulative probability of non-progression of visual field (VF) loss was significantly greater in the highly myopic group (10-year survival rate, 73.7%±6.8%) than in the non-myopic group (10-year survival rate, 46.3%±5.8%; log-rank test, P=0.0142). The occurrence of disk hemorrhage (DH) in the non-myopic group (1.60±3.04) was significantly greater than that in the highly myopic group (0.93±2.13, P=0.0311). The cumulative probability of DH was significantly lower in the highly myopic group (10-year survival rate, 26.4%±5.4%) than in the non-myopic group (10-year survival rate, 47.2%±6.6%, P=0.0413).

Conclusion: Highly myopic POAG is considered as a combination of myopic optic neuropathy and glaucomatous optic neuropathy (GON). If GON is predominant, it has frequent DH and more progressive VF loss. However, when the myopic optic neuropathy is predominant, it has less DH and less progressive VF loss.

Keywords: disk hemorrhage; high myopia; myopic glaucoma; open-angle glaucoma; visual field defect progression.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The cumulative probability of non-progression of VF loss in the highly myopic group and the non-myopic group. Notes: The cumulative probability of non-progression of VF loss was significantly greater in the highly myopic group (10-year survival rate, 73.7%±6.8%) than in the non-myopic group (10-year survival rate, 46.3%±5.8%; log-rank test, P=0.0142). Abbreviation: VF, visual field.
Figure 2
Figure 2
The cumulative probability of occurrence of DH in the highly myopic group and the non-myopic group. Notes: The cumulative probability of DH incidences was significantly greater in the non-myopic group (10-year survival rate, 47.2%±6.6%) than in the highly myopic group (10-year survival rate, 26.4%±5.4%; log-rank test, P=0.0413). Abbreviation: DH, disk hemorrhage.
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