Myopic glaucomatous eyes with or without optic disc shape alteration: a longitudinal study

Kwon, Junki; Sung, Kyung Rim; Park, Ji Min

doi:10.1136/bjophthalmol-2016-309914

Cited by 10 publications

(11 citation statements)

References 24 publications

(17 reference statements)

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“…In this study, the myopic eyes with tilted disc showed a more stable glaucoma progression than the eyes without tilted disc. Several previous studies 6,8,10,20 have reported similar results, but the mechanism is unclear. Myopic eyes are known to experience tilting of disc and deformation of lamina cribrosa (LC) during axial elongation.…”

Section: Discussionmentioning

confidence: 72%

“…Myopic eyes are known to experience tilting of disc and deformation of lamina cribrosa (LC) during axial elongation. 5,6,10,21 The damage of LC will not proceed any longer after the change of myopia is stabilized as an adult. 6,20 In other words, glaucomatous changes in the tilted disc eyes may be associated with myopic changes that occur during childhood or adolescence.…”

Section: Discussionmentioning

confidence: 99%

“…Optic disc tilt was defined according to the relevant previous publications, using the ovality index. [10][11][12] Tilt ratio was calculated as the ratio between the longest and shortest optic disc diameters. The measurements were made from the disc margins defined as the inner border of the peripapillary scleral ring.…”

Section: Methodsmentioning

confidence: 99%

“…13 When the tilt ratio was ‡1.3, the optic disc was classified as tilted disc. 10,12 Two observers (BRS, JWJ), who were masked to all other patient information, independently evaluated all photographs. In cases of disagreement (>0.2 difference of tilt ratio), a third glaucoma specialist (KHP) served as an adjudicator.…”

Section: Methodsmentioning

confidence: 99%

“…However, the relationship between tilted disc and glaucoma progression is not clear, as several other factors also are known to affect glaucoma progression. 6,7,9 Recently, Kwon et al 10 have shown significant differences in glaucoma progression between eyes with and without optic disc tilt. However, if the degree of myopia between the two groups is different, it is difficult to determine whether there is a difference in progression due to myopia itself or due to the myopic tilted disc.…”

mentioning

confidence: 99%

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Optic Disc Tilt and Glaucoma Progression in Myopic Glaucoma: A Longitudinal Match-Pair Case-Control Study

Seol

Park

Jeoung

2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the long-term follow-up results for tilted disc eyes and case-matched nontilted disc eyes in myopic glaucoma patients. METHODS. We included 28 tilted disc eyes of 28 myopic primary open-angle glaucoma (POAG) patients and 28 case-matched nontilted disc eyes of 28 myopic POAG patients with minimum 5 years of follow-up. One matching set included one tilted disc eye and one case-matched nontilted disc eye. The eyes had similar characteristics including age, axial length, baseline intraocular pressure, and initial visual field mean deviation. The progression of glaucoma was evaluated in functional and structural tests. Kaplan-Meier survival analysis and Cox proportional hazards model were used to evaluate glaucoma progression and identify the factors predictive of glaucoma progression. RESULTS. The mean age and follow-up duration were 50.1 6 11.7 years and 90.8 6 38.1 months, respectively. Of the 56 total eyes, glaucoma progression was detected in 22 (39.3%). Of these, 16 of the 28 nontilted disc eyes (57.1%) and 6 of the 28 tilted disc eyes (21.4%) demonstrated glaucoma progression. Patients with nontilted disc had a greater cumulative probability of progression than those with disc tilt (P ¼ 0.01 by log-rank test). A Cox proportional hazards model indicated that lower disc tilt ratio and the presence of disc hemorrhage were significantly associated with disease progression (P ¼ 0.02 and 0.04, respectively). CONCLUSIONS. In myopic POAG patients, more stable courses were found in eyes with disc tilt than in those without disc tilt. Clinical evaluation of optic disc morphology might help to predict future progression in myopic glaucomatous eyes.

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Section: Discussionmentioning

confidence: 72%