High myopia and glaucoma susceptibility the Beijing Eye Study.
OBJECTIVE
To evaluate whether marked myopia, compared with moderate myopia and low myopia, is associated with a higher prevalence of glaucomatous optic nerve damage.


METHODS
Population-based cross-sectional study.


METHODS
Four thousand four hundred thirty-nine of 5324 subjects 40 years or older were invited to participate (response rate, 83.4%). The group was stratified according to refractive error into high myopia (myopia > -8 diopters [D]), marked myopia (<-6 to -8 D), moderate myopia (<-3 to -6 D), low myopia (<-0.5 to -3 D), emmetropia (-0.5 to + <2 D), and hyperopia (>+ 2 D) subgroups.


METHODS
Morphologic assessment of optic disc monoscopic photographs.


METHODS
Morphologic optic disc parameters and intraocular pressure (IOP).


RESULTS
For 4319 (97.3%) subjects (8484 eyes), optic disc photographs were evaluated. Prevalence of glaucomatous optic nerve atrophy as defined by the glaucomatous optic nerve head appearance did not vary significantly (P = 0.77; odds ratio [OR], 1.2; 95% confidence interval [CI], 0.38-3.81) between the highly myopic group and the group with marked myopia. In both refractive groups combined, glaucoma frequency seemed to be higher (P = 0.075; OR, 2.28; 95% CI, 0.99-5.25) higher than in the group with moderate myopia; it was significantly (P = 0.001; OR, 3.5; 95% CI, 1.71-7.25) higher than in the group with low myopia; significantly (P<0.001; OR, 7.56; 95% CI, 3.98-14.35) higher than in the group with emmetropia; and significantly (P = 0.005; OR, 4.23; 95% CI, 1.57-11.45) higher than in the group with hyperopia. Glaucoma frequency did not vary significantly between the hyperopic group and the emmetropic group (P = 0.17), the group with low myopia (P = 0.83), and the group with moderate myopia (P = 0.32). Intraocular pressure did not vary significantly (P>0.10) between any of the subgroups. Similar results were obtained for the frequency of glaucoma defined as glaucomatous optic disc appearance and visual field defects. In binary logistic regression analysis, presence of glaucoma was significantly associated with the myopic refractive error (P<0.001), age (P<0.001), and IOP (P<0.001).


CONCLUSIONS
Marked to high myopia with a myopic refractive error exceeding -6 D may be a risk factor associated with glaucomatous optic neuropathy.
Xu
Liang
L
Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing, China.
Wang
Yaxing
Y
Wang
Shuang
S
Wang
Yun
Y
Jonas
Jost B
JB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D005260:Female; D005902:Glaucoma, Open-Angle / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000145:classification / Q000150:complications*; D016017:Odds Ratio; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population