Park Hae-Young Lopilly, Hong Kyung Euy, Park Chan Kee
From the Department of Ophthalmology and Visual Science (H-YLP); and Department of Ophthalmology and Visual Science (KEH), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Medicine (Baltimore). 2016 May;95(21):e3500. doi: 10.1097/MD.0000000000003500.
Myopia is rapidly increasing in young populations and patients with glaucoma associated with myopia are reported to be young aged in East Asia. These young patients have a longer life expectancy, which increases their risk of end-of-life visual disabilities. There is a need to understand the clinical course of myopic glaucoma patients, which may be important for the care of these myopic populations. In this study, we evaluated the relationship between the age at presentation and the rate of glaucoma progression in the visual field (VF) according to the presence of myopia. The study was conducted as a prospective observational study including 179 patients with open-angle glaucoma who had undergone at least 5 VF examinations with a follow-up of at least 5 years. The progression rate of the mean deviation (MD) and the pattern standard deviation (PSD) are expressed as change in decibels (dB) per year. The slopes of the MD and PSD were calculated by linear regression analyses. Factors related to the slope of VF MD changes were analyzed with correlation and regression analyses. The slope of the linear fit line plotted against age at presentation and the rate of change in the VF MD was -0.026 (P < 0.001) in the myopic group and -0.008 (P = 0.167) in the nonmyopic group; the relationship was more prominent in the myopic group than the nonmyopic group. In the myopic group, age (β = -0.417; 95% confidence intervals (CI), -0.651 to -0.200; P = 0.050) and baseline untreated intraocular pressure (β = -0.179; 95% CI, -0.331 to -0.028; P = 0.022) were significantly related to the rate of change in the MD, which was only the presence of disc hemorrhage (β = -0.335; 95% CI, -0.568 to -0.018; P = 0.022) in the nonmyopic group. Age at presentation was significantly related to the rate of change in the VF in glaucomatous eyes with myopia compared to eyes without myopia. Older age was significantly related to the rate of change in the VF only in myopic glaucomatous eyes.
近视在年轻人群中迅速增加，据报道，在东亚，与近视相关的青光眼患者年龄较轻。这些年轻患者预期寿命较长，这增加了他们在生命末期出现视力残疾的风险。有必要了解近视性青光眼患者的临床病程，这对于照顾这些近视人群可能很重要。在本研究中，我们根据近视的存在情况，评估了就诊年龄与视野（VF）中青光眼进展率之间的关系。该研究作为一项前瞻性观察性研究进行，纳入了179例开角型青光眼患者，这些患者至少接受了5次VF检查，随访时间至少为5年。平均偏差（MD）和模式标准偏差（PSD）的进展率以每年分贝（dB）的变化表示。MD和PSD的斜率通过线性回归分析计算。通过相关性和回归分析分析与VF MD变化斜率相关的因素。近视组中，绘制的线性拟合线斜率与就诊年龄和VF MD变化率之间为-0.026（P<0.001），非近视组为-0.008（P=0.167）；近视组中的这种关系比非近视组更显著。在近视组中，年龄（β=-0.417；95%置信区间（CI），-0.651至-0.200；P=0.050）和基线未治疗眼压（β=-0.179；95%CI，-0.331至-0.028；P=0.022）与MD变化率显著相关，而在非近视组中仅视盘出血的存在（β=-0.335；95%CI，-0.568至-0.018；P=0.022）与MD变化率显著相关。与无近视的眼睛相比，近视性青光眼患者的就诊年龄与VF变化率显著相关。仅在近视性青光眼患者中，年龄较大与VF变化率显著相关。
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