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Y. Tamura, C. Matsumoto, S. Okuyama, S. Takada, F. Tanabe, S. Hashimoto, E. Arimura, Y. Shimomura; Myopia as a Risk Factor for Progression of Visual Field Loss in Young Patients With Primary Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4027.
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To demonstrate the clinical characteristics of primary open-angle glaucoma (POAG) in patients under 40 years of age.
Subjects in this retrospective study were 51 eyes of 51 patients (43 POAG, 1 POAG suspect and 7 ocular hypertension (OH)) whose initial visits to our clinic were under 40 (range: 9.7 - 39.6) years of age and follow-up periods were longer than 4 (range: 4.1-24.4) years. All of them had 5 or more reliable visual field test results using Octopus program G2 normal strategy. We evaluated the effect of age and myopia on the changes in refraction as spherical equivalent (SE), the ratio of the distance between center of the disc and the fovea (DM) to the disc diameter (DD) (DM/DD ratio) on fundus photograph, mean defects (MD) in the whole field and the clusters of program G2 with Eye SuiteTM Perimetry (HAAG-STREIT).
The DM/DD ratio increased with the advance of myopia in patients under 20 years of age. In comparison with 25 eyes with the initial SE > -3D to 26 eyes with the initial SE ≤-3D, the clusters with significant deterioration of MD were showed more frequently in moderate or high myopic eyes than the others. In eyes with the initial SE ≤-3D, the deterioration of MD in the lower cluster adjacent of fixation point were less frequently than those in the other clusters.
Young patients under 20 years old with POAG, POAG suspects or OH can have substantial changes in the disc shape and refraction. The risk for and the pattern of the progression of the visual field loss should be taken into consideration in young myopic patients with POAG.
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