Is Myopic Optic Disc Appearance a Risk Factor for Rapid Progression in Medically Treated Glaucomatous Eyes With Confirmed Visual Field Progression?

PURPOSE

To investigate visual field (VF) progression rates in glaucomatous eyes with myopic optic disc appearance, refractive error, and progressive VF changes and to compare the rates with those of a nonmyopic group.

PATIENTS AND METHODS

Data on 158 eyes from 131 patients with open-angle glaucoma who had progressive VF deterioration during follow-up were retrospectively analyzed. The myopic and nonmyopic groups were compared in terms of rates of change of mean thresholds in global and regional areas using central 10 degrees, peripheral 10 to 24 degrees, and glaucoma hemifield test maps by using a linear-mixed model and controlling for confounding covariates. Clinical factors associated with rapid VF progression at global and regional VF areas were investigated in each group.

RESULTS

The 2 groups did not significantly differ in the mean global VF progression rate (-0.36 vs. -0.35 dB/y, respectively; P=0.951). Likewise, both groups showed similar VF progression rates at all regional clusters (P>0.05). No significant association was found between the rate of VF change and clinical factors in the myopic group. The mean follow-up intraocular pressure was significantly associated with VF progression rates in the nonmyopic group (P<0.05).

CONCLUSIONS

Open-angle glaucoma eyes with myopic optic disc appearance experiencing progressive VF changes showed similar VF progression rates globally and regionally when compared with nonmyopic eyes after controlling for clinical factors related to VF progression. None of the clinical factors in the myopic group were significantly associated with VF progression rate, whereas the mean follow-up intraocular pressure was in the nonmyopic group.