Choi Eun Young, Wong Raymond C S, Thein Thuzar, Pasquale Louis R, Shen Lucy Q, Wang Mengyu, Li Dian, Jin Qingying, Wang Hui, Baniasadi Neda, Boland Michael V, Yousefi Siamak, Wellik Sarah R, De Moraes Carlos G, Myers Jonathan S, Bex Peter J, Elze Tobias
Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA 02114, USA.
Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.
J Clin Med. 2021 Jun 25;10(13):2796. doi: 10.3390/jcm10132796.
Myopia has been discussed as a risk factor for glaucoma. In this study, we characterized the relationship between ametropia and patterns of visual field (VF) loss in glaucoma. Reliable automated VFs (SITA Standard 24-2) of 120,019 eyes from 70,495 patients were selected from five academic institutions. The pattern deviation (PD) at each VF location was modeled by linear regression with ametropia (defined as spherical equivalent (SE) starting from extreme high myopia), mean deviation (MD), and their interaction (SE × MD) as regressors. Myopia was associated with decreased PD at the paracentral and temporal VF locations, whereas hyperopia was associated with decreased PD at the Bjerrum and nasal step locations. The severity of VF loss modulated the effect of ametropia: with decreasing MD and SE, paracentral/nasal step regions became more depressed and Bjerrum/temporal regions less depressed. Increasing degree of myopia was positively correlated with VF depression at four central points, and the correlation became stronger with increasing VF loss severity. With worsening VF loss, myopes have increased VF depressions at the paracentral and nasal step regions, while hyperopes have increased depressions at the Bjerrum and temporal locations. Clinicians should be aware of these effects of ametropia when interpreting VF loss.
近视已被作为青光眼的一个风险因素进行讨论。在本研究中，我们描述了屈光不正与青光眼视野（VF）缺损模式之间的关系。从五家学术机构选取了70495例患者的120019只眼的可靠自动视野检查结果（SITA标准24-2）。以屈光不正（定义为从极端高度近视开始的等效球镜度（SE））、平均缺损（MD）及其相互作用（SE×MD）作为回归变量，通过线性回归对每个视野位置的模式偏差（PD）进行建模。近视与旁中心和颞侧视野位置的PD降低相关，而远视与 Bjerrum区和鼻侧阶梯位置的PD降低相关。视野缺损的严重程度调节了屈光不正的影响：随着MD和SE降低，旁中心/鼻侧阶梯区域变得更加凹陷，而Bjerrum区/颞侧区域凹陷程度减轻。近视程度增加与四个中心点的视野凹陷呈正相关，且随着视野缺损严重程度增加，这种相关性变得更强。随着视野缺损加重，近视患者在旁中心和鼻侧阶梯区域的视野凹陷增加，而远视患者在Bjerrum区和颞侧位置的凹陷增加。临床医生在解释视野缺损时应注意屈光不正的这些影响。
