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Myopia not associated with glaucoma progression
The progression of glaucoma was not associated with any levels of myopia, according to a retrospective cohort study recently published in Investigational Ophthalmology & Visual Science.
Lee and colleagues sorted 369 eyes from 369 patients with primary open-angle glaucoma into three myopia categories: nonmyopic (greater than 0 D), mild to moderate (0 D to -6 D) and highly myopic (less than -6 D). They measured glaucoma progression by serial visual field data or optic disc/retinal nerve fiber layer (RNFL) photographs and utilized Cox's proportional hazard models to identify any associations.
"Our results showed that no level of myopia was associated with glaucoma progression using either the visual field or optic disc/RNFL criterion," the authors concluded. "High myopia was a preventive factor for glaucoma progression when using optic disc/RNFL criteria."
They continued: "This may be interpreted as a lower progression detection rate when using structural criteria that occurs because of a difficulty in detecting changes in the optic disc/RNFL in highly myopic eyes, or may mean that some highly myopic glaucomatous eyes are not true cases of glaucoma." – by Chelsea Frajerman
Disclosure: The authors reported no relevant financial interests.
Perspective
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Myopia is epidemic in the adult population and, therefore, commonly found in glaucoma patients. It has been flagged as a risk factor for developing glaucoma, but whether or not it is a driving force in the progression of the disease is not known.
This study investigated Korean glaucoma patients to determine if higher rates of progression were associated with myopia. After analyzing the study group data, the authors found no association.
In my practice, a majority of glaucoma patients are Caucasian and African-American, so I would need to account for this when considering these study results. Also, the authors used serial stereoscopic optic disc/retinal nerve fiber layer photography and threshold visual field analysis to determine glaucoma progression. Most contemporary practices also utilize serial retinal nerve fiber layer (RNFL) OCT analysis to detect progression. It would be interesting to see if progression rates in myopic glaucoma patients would yield the same results using the additional criteria of serial RNFL OCT.