Mitchell P, Hourihan F, Sandbach J, Wang J J
Department of Ophthalmology, University of Sydney, Westmead Hospital, NSW, Australia.
Ophthalmology. 1999 Oct;106(10):2010-5. doi: 10.1016/s0161-6420(99)90416-5.
To quantify the relationship between myopia and open-angle glaucoma, ocular hypertension (OH), and intraocular pressure (IOP) in a representative older population.
Cross-sectional population-based study of 3654 Australians 49 to 97 years of age.
Subjects with any myopia (> or =-1.0 diopter [D]) were identified by a standardized subjective refraction and categorized into low myopia (> or =-1.0 D to <-3.0 D) or moderate-to-high myopia (> or =-3.0 D). Glaucoma was diagnosed from characteristic visual field loss, combined with optic disc cupping and rim thinning, without reference to IOP. Ocular hypertension was diagnosed when applanation IOP was greater than 21 mmHg in either eye in the absence of glaucomatous visual field and optic disc changes.
General estimating equation models were used to assess associations between eyes with myopia and either glaucoma or OH.
Glaucoma was present in 4.2% of eyes with low myopia and 4.4% of eyes with moderate-to-high myopia compared to 1.5% of eyes without myopia. The relationship between glaucoma and myopia was maintained after adjusting for known glaucoma risk factors, odds ratio (OR) of 2.3, and 95% confidence intervals (CI) of 1.3 to 4.1 for low myopia. It was stronger for eyes with moderate-to-high myopia (OR, 3.3; CI, 1.7-6.4). Only a borderline relationship was found with OH, OR of 1.8 (CI, 1.2-2.9) for low myopia, and OR of 0.9 (CI, 0.4-2.0) for moderate-to-high myopia. Mean IOP was approximately 0.5 mmHg higher in myopic eyes compared to nonmyopic eyes.
This study has confirmed a strong relationship between myopia and glaucoma. Myopic subjects had a twofold to threefold increased risk of glaucoma compared with that of nonmyopic subjects. The risk was independent of other glaucoma risk factors and IOP.
量化在具有代表性的老年人群中近视与开角型青光眼、高眼压症（OH）和眼压（IOP）之间的关系。
对3654名年龄在49至97岁的澳大利亚人进行基于人群的横断面研究。
通过标准化主观验光确定有任何近视（≥-1.0屈光度[D]）的受试者，并将其分为低度近视（≥-1.0 D至<-3.0 D）或中度至高度近视（≥-3.0 D）。青光眼根据典型的视野缺损，结合视盘杯状凹陷和边缘变薄进行诊断，不考虑眼压。当在没有青光眼性视野和视盘改变的情况下，任一眼睛的压平眼压大于21 mmHg时，诊断为高眼压症。
使用一般估计方程模型评估近视眼睛与青光眼或高眼压症之间的关联。
低度近视眼中青光眼的患病率为4.2%，中度至高度近视眼中为4.4%，而无近视的眼中为1.5%。在调整已知的青光眼危险因素后，青光眼与近视之间的关系依然存在，低度近视的比值比（OR）为2.3，95%置信区间（CI）为1.3至4.1。中度至高度近视的眼睛中这种关系更强（OR，3.3；CI，1.7 - 6.4）。与高眼压症仅发现一种临界关系，低度近视的OR为1.8（CI，1.2 - 2.9），中度至高度近视的OR为0.9（CI，0.4 - 2.0）。近视眼睛的平均眼压比非近视眼睛高约0.5 mmHg。
本研究证实了近视与青光眼之间存在密切关系。近视受试者患青光眼的风险比非近视受试者增加了两倍至三倍。该风险独立于其他青光眼危险因素和眼压。
