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Tiffany J Au, Michele Lee, Kuldev Singh, Robert Chang; Three year follow-up of serial structural and function testing in high myopes without elevated intraocular pressure. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3992.
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To describe longitudinal Spectral-Domain Optical Coherence Tomography (SD-OCT) and Humphrey Visual Field (HVF) changes in high myopes presenting as glaucoma suspects.
In a retrospective cohort study from a university hospital based glaucoma practice, 20 subjects (38 eyes) met the following inclusion criteria: (1) high myopes – defined as manifest refraction ≥ -5 diopters (16 patients, 30 eyes) or documented to have “high myopia” or “pathologic myopia” (4 patients, 8 eyes), (2) had ≥ 3 visual fields over at least 3 years, (3) had ≥1 OCT RNFL, and (4) diagnosed as glaucoma suspects without any surgical or medical treatment for glaucoma. Eighteen other patients who met all other inclusion criteria were excluded for receiving glaucoma treatment.
The 20 patients (38 total eyes) who met inclusion criteria had an average age of 47.7 (range: 27-70) years and corneal thickness of 576.4μm. Eyes were followed with an average of 5.8 visual fields (range: 3-18) and 4.0 (range: 1-6) OCT RNFL tests over the study period. Average intraocular pressure was 15.8 mmHg (range: 12-22). The average RNFL was 75μm (range: 64-112), and the average inferior and superior quadrants measured 94μm (range: 55-143) and 101μm (range: 56-121) respectively. The average mean deviation was -3.43, pattern standard deviation was 3.34. Visual field defects were characterized as: nonspecific depression (8/38), enlarged blind spot (6/38), superior or inferior arcuate defect (4/38), nasal step (3/38), and paracentral scotoma (2/38). Thirty nine percent (15/38) of visual fields were determined to be within normal limits. Glaucoma progression analysis (GPA) was only available in 15 eyes each for HVF and OCT RNFL testing; amongst which, 15/15 and 13/15 (86.7%) did not demonstrate significant progression on HVF and OCT RNFL testing respectively.
High myopes with visual field defects and abnormal OCT RNFLs rarely showed changes characteristic of a progressive optic neuropathy such as glaucomatous disease.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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