Impact of Age and Myopia on the Rate of Visual Field Progression in Glaucoma Patients

Abstract

Myopia is rapidly increasing in young populations and patients with glaucoma associated with myopia are reported to be young aged in East Asia. These young patients have a longer life expectancy, which increases their risk of end-of-life visual disabilities. There is a need to understand the clinical course of myopic glaucoma patients, which may be important for the care of these myopic populations. In this study, we evaluated the relationship between the age at presentation and the rate of glaucoma progression in the visual field (VF) according to the presence of myopia. The study was conducted as a prospective observational study including 179 patients with open-angle glaucoma who had undergone at least 5 VF examinations with a follow-up of at least 5 years. The progression rate of the mean deviation (MD) and the pattern standard deviation (PSD) are expressed as change in decibels (dB) per year. The slopes of the MD and PSD were calculated by linear regression analyses. Factors related to the slope of VF MD changes were analyzed with correlation and regression analyses. The slope of the linear fit line plotted against age at presentation and the rate of change in the VF MD was −0.026 (P < 0.001) in the myopic group and −0.008 (P = 0.167) in the nonmyopic group; the relationship was more prominent in the myopic group than the nonmyopic group. In the myopic group, age (β = −0.417; 95% confidence intervals (CI), −0.651 to −0.200; P = 0.050) and baseline untreated intraocular pressure (β = −0.179; 95% CI, −0.331 to −0.028; P = 0.022) were significantly related to the rate of change in the MD, which was only the presence of disc hemorrhage (β = −0.335; 95% CI, −0.568 to −0.018; P = 0.022) in the nonmyopic group. Age at presentation was significantly related to the rate of change in the VF in glaucomatous eyes with myopia compared to eyes without myopia. Older age was significantly related to the rate of change in the VF only in myopic glaucomatous eyes.

Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns

“…While the rate of VF loss in POAG eyes, [41][42][43][44][45][46][47][48][49][50][51][52] as well as differences between the patterns of VF loss in POAG and PACG eyes, 27,30,34,53 has been reported previously, this is, to our knowledge, the first study directly investigating the differences in the rate of VF loss as well as the superior-inferior asymmetry between POAG and PACG eyes with automated perimetry. Lee and colleauges compared the rate of VF loss using the Goldmann perimetry; however, their relatively small number of eyes (25 POAG eyes and 23 PACG eyes) makes the comparison challenging.…”

Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns

“…While the rate of VF loss in POAG eyes, [41][42][43][44][45][46][47][48][49][50][51][52] as well as differences between the patterns of VF loss in POAG and PACG eyes, 27,30,34,53 has been reported previously, this is, to our knowledge, the first study directly investigating the differences in the rate of VF loss as well as the superior-inferior asymmetry between POAG and PACG eyes with automated perimetry. Lee and colleauges compared the rate of VF loss using the Goldmann perimetry; however, their relatively small number of eyes (25 POAG eyes and 23 PACG eyes) makes the comparison challenging.…”

The Impact of Myopia on Regional Visual Field Loss and Progression in Glaucoma

“… 11 We are not able to account for these factors as the Glaucoma Research Network does not provide information about pseudophakia; however, limitation in ability to account for pseudophakia is not unique to our study. 39 Additionally, without diagnostic or IOP information, our ability to conclude that VF progression is due to glaucoma is somewhat limited. However, prior work using this large dataset has also been predicated on the fact that VF loss in cases from the Glaucoma Research Network are likely mostly occurring due to glaucoma, given the dataset's origins.…”

Identifying Factors Associated With Fast Visual Field Progression in Patients With Ocular Hypertension Based on Unsupervised Machine Learning

“…4,41,42 Numerous studies have reported thinner CCT as a predictor of glaucoma progression, [41][42][43] which agrees with our findings. Although PSD 44 and RE 45,46 have been reported to be associated with glaucoma and its progression but the role of myopia in glaucoma progression is controversial, some studies suggest myopia as a risk factor for glaucoma progression and myopic eyes with higher than −4.0 D tended to progress faster, 47 whereas another study showing myopia is preventive of VF progression. 48 In this study, we also observed that myopia is protective of VF progression.…”

Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns

“…While the rate of VF loss in POAG eyes, [41][42][43][44][45][46][47][48][49][50][51][52] as well as differences between the patterns of VF loss in POAG and PACG eyes, 27,30,34,53 has been reported previously, this is, to our knowledge, the first study directly investigating the differences in the rate of VF loss as well as the superior-inferior asymmetry between POAG and PACG eyes with automated perimetry. Lee and colleauges compared the rate of VF loss using the Goldmann perimetry; however, their relatively small number of eyes (25 POAG eyes and 23 PACG eyes) makes the comparison challenging.…”

The Impact of Myopia on Regional Visual Field Loss and Progression in Glaucoma

“… 11 We are not able to account for these factors as the Glaucoma Research Network does not provide information about pseudophakia; however, limitation in ability to account for pseudophakia is not unique to our study. 39 Additionally, without diagnostic or IOP information, our ability to conclude that VF progression is due to glaucoma is somewhat limited. However, prior work using this large dataset has also been predicated on the fact that VF loss in cases from the Glaucoma Research Network are likely mostly occurring due to glaucoma, given the dataset's origins.…”

Identifying Factors Associated With Fast Visual Field Progression in Patients With Ocular Hypertension Based on Unsupervised Machine Learning

“…4,41,42 Numerous studies have reported thinner CCT as a predictor of glaucoma progression, [41][42][43] which agrees with our findings. Although PSD 44 and RE 45,46 have been reported to be associated with glaucoma and its progression but the role of myopia in glaucoma progression is controversial, some studies suggest myopia as a risk factor for glaucoma progression and myopic eyes with higher than −4.0 D tended to progress faster, 47 whereas another study showing myopia is preventive of VF progression. 48 In this study, we also observed that myopia is protective of VF progression.…”

Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns

“…While the rate of VF loss in POAG eyes, [41][42][43][44][45][46][47][48][49][50][51][52] as well as differences between the patterns of VF loss in POAG and PACG eyes, 27,30,34,53 has been reported previously, this is, to our knowledge, the first study directly investigating the differences in the rate of VF loss as well as the superior-inferior asymmetry between POAG and PACG eyes with automated perimetry. Lee and colleauges compared the rate of VF loss using the Goldmann perimetry; however, their relatively small number of eyes (25 POAG eyes and 23 PACG eyes) makes the comparison challenging.…”

The Impact of Myopia on Regional Visual Field Loss and Progression in Glaucoma

“… 11 We are not able to account for these factors as the Glaucoma Research Network does not provide information about pseudophakia; however, limitation in ability to account for pseudophakia is not unique to our study. 39 Additionally, without diagnostic or IOP information, our ability to conclude that VF progression is due to glaucoma is somewhat limited. However, prior work using this large dataset has also been predicated on the fact that VF loss in cases from the Glaucoma Research Network are likely mostly occurring due to glaucoma, given the dataset's origins.…”

Identifying Factors Associated With Fast Visual Field Progression in Patients With Ocular Hypertension Based on Unsupervised Machine Learning

“…4,41,42 Numerous studies have reported thinner CCT as a predictor of glaucoma progression, [41][42][43] which agrees with our findings. Although PSD 44 and RE 45,46 have been reported to be associated with glaucoma and its progression but the role of myopia in glaucoma progression is controversial, some studies suggest myopia as a risk factor for glaucoma progression and myopic eyes with higher than −4.0 D tended to progress faster, 47 whereas another study showing myopia is preventive of VF progression. 48 In this study, we also observed that myopia is protective of VF progression.…”