Myopia and advanced-stage open-angle glaucoma.
OBJECTIVE
To investigate the effect of myopic refraction on the central visual field in patients with advanced open-angle glaucoma (OAG).


METHODS
Multicenter cross-sectional study.


METHODS
Three hundred thirteen OAG eyes (176 eyes of 176 primary open-angle glaucoma [POAG] patients and 137 eyes of 137 normal-tension glaucoma [NTG] patients) with clear ocular media and a mean deviation (MD) <-15 dB. Patients with a recorded maximum intraocular pressure (IOP) of 22 mmHg or greater were classified as POAG, and those with an IOP of 21 mmHg or less were classified as NTG.


METHODS
Multiple regression analysis was used to study the influence of refraction on 12 central test points of the C30-2 Humphrey program, and the differences in visual field defects between POAG and NTG eyes were examined using logistic discriminant analysis. In the multiple regression analysis, total deviation (TD) of the 12 test points was graded and used as the dependent variable, and MD and the spherical equivalent refraction were the explanatory variables. In the logistic discrimination analysis, TD, MD, and refraction were covariants that determined the OAG subtypes.


METHODS
TD values of the 12 central test points (C30-2 program).


RESULTS
Higher myopic refraction was significantly associated with more damage at a point just temporal and inferior to the fixation point in POAG eyes, whereas it was significantly associated with less damage at test points just temporal and superior to the fixation point in NTG eyes. After correcting for the influence of refraction, POAG eyes had significantly more damage at a test point just temporal and inferior to the fixation point, whereas NTG eyes had significantly more damage at those test points nasal and inferior to the fixation point.


CONCLUSIONS
High myopia constitutes a threat to the remaining lower cecocentral visual field and is one of the factors that interfere with the quality of vision in advanced OAG with high IOP but not low IOP.
Mayama
Chihiro
C
Department of Ophthalmology, the University of Tokyo School of Medicine, Tokyo, Japan.
Suzuki
Yasuyuki
Y
Araie
Makoto
M
Ishida
Kyoko
K
Akira
Tsuji
T
Yamamoto
Tetsuya
T
Kitazawa
Yoshiaki
Y
Funaki
Shigeo
S
Shirakashi
Motohiro
M
Abe
Haruki
H
Tsukamoto
Hidetoshi
H
Okada
Koji
K
Mishima
Hiromu K
HK
D003430:Cross-Sectional Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology*; D012029:Refraction, Ocular; D014786:Vision Disorders / Q000503:physiopathology*; D014794:Visual Fields