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A Soefker, JB Jonas, P Martus, WM Budde; Anisometropia and Degree of Optic Nerve Damage in Chronic Open-Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):283.
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Purpose: To address the question whether the refractive error plays a role in the amount of optic nerve damage in glaucoma, the purpose of the present study was to compare inter-eye differences in refractive error with inter-eye differences in parameters indicating the degree of glaucomatous optic nerve damage, and to compare interindividual differences in refractive error with interindividual differences in neuroretinal rim area and visualfield loss. Methods: The comparative clinical observational study included 1444 eyes of 876 patients with primary or secondary chronic open-angle glaucoma. Patients with a highly myopic refractive error exceeding -8 diopters were excluded due to differences in the anatomy of the optic nerve head. For all patients, color stereo optic disc photographs had been taken and were morphometrically evaluated. Main outcome measures were refractive error, neuroretinal rim area, horizontal and vertical cup/disc diameter ratios, and visual field loss. Result: In an interindividual statistical analysis, area of neuroretinal rim, horizontal and vertical cup/disc diameter ratios, and mean visual field loss were not significantly (P≷0.10) correlated with the refractive error. In an intraindividual comparison, inter-eye differences in refractive error were not significantly (P≷0.05) correlated with inter-eye differences in neuroretinal rim area and mean visual field defect. The eye with the more myopic refractive error and the contralateral eye with the less myopic refractive error did not vary significantly in neuroretinal rim area and mean visual field defect. Conclusion: For non-highly myopic patients with primary or secondary chronic open-angle glaucoma, the refractive error may not play a major role for the amount of glaucomatous optic neuropathy and myopia may not be an important risk indicator for glaucoma.
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