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S. Hung, M. Pekmezci, S. C. Lin; Glaucoma Susceptibility in Myopic Young Adults. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2678.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the association of suspicious glaucomatous changes in young patients with various levels of myopia.
In this prospective study which recruited students in the health sciences, the right eye was evaluated in participants who were less than or equal to 40 years of age. Spherical equivalent (SE), axial length (AL), and intraocular pressure (IOP) were measured. Confocal scanning laser ophthalmoscopy (CSLO) was used to evaluate retinal nerve fiber layer (RNFL) thickness, disc and rim area, linear cup-to-disc ratio, and Moorfields Regression Analysis (MRA) classification.
There were 63 subjects of average age 24.3 years (21-40 years). Asians (n=35, 55.6%) and Caucasians (n=21, 33.3%) were the most represented ethnic groups. Mean SE was -4.08 D (+0.52 to -15.1 D) and mean AL was 25.03 mm (23.09-29.09 mm). Mean IOP was 14.4 mmHg (9-21 mmHg). RNFL thickness decreased with higher negative SE and longer AL (p=0.002 and p=0.010, respectively). When refractive error was stratified to emmetropia (+1 to -1 D; 17.4%), low-moderate myopia (<-1 to -6 D; 57.1%), and high myopia (<-6 D; 25.4%), the correlation of RNFL thickness was also significant (p=0.030). Disc area, rim area, and cup-to-disc ratio were not statistically significant for either SE or AL. Asians had more negative SE (mean -5.51 vs -2.80 D) and higher AL (25.48 vs 24.49 mm) than Caucasians. Asians had lower cup-to-disc ratio (0.36 vs 0.42) compared to Caucasians. MRA classification of outside normal limits was 8.57% for Asians and 4.76% for Caucasians.
There appears to be a correlation between decreasing RNFL thickness and higher negative spherical equivalent and longer axial length. Any associations between myopia and linear cup-to-disc ratio, rim area, or cup area were not significant. Asians had a higher negative spherical equivalent and longer axial length than Caucasians in our study population but for unclear reasons, had smaller cup-to-disc ratios and more chance of MRA classification as outside normal limits. Future increased numbers of participants and expected long-term follow up will help us distinguish potential risk factors for glaucoma suspicion among this young cohort.
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