Institut Français de Myopie, Hôpital Fondation Adolphe de Rothschild, Paris, France; Singapore Eye Research Institute, Singapore; Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany.
Ufa Eye Research Institute, Ufa, Russia.
Ophthalmology. 2024 Dec;131(12):1427-1435. doi: 10.1016/j.ophtha.2024.07.003. Epub 2024 Jul 5.
Prevalence of myopia and vision impairment due to myopic macular degeneration and myopia-related optic neuropathies have markedly increased worldwide. We evaluated whether myopia is associated with other ocular disorders.
Population-based studies conducted in Russia, China, and India.
The Russian Ural Eye and Medical Study (UEMS) and the Beijing Eye Study (BES) included 5899 individuals and 4439 individuals (all aged 40+ years), respectively, and the Central India Eye and Medical Study (CIEMS) consisted of 4711 individuals aged 30+ years. The studies were conducted in rural and urban regions in Bashkortostan/Russia, Nagpur/India, and Beijing/China.
The participants underwent a series of ophthalmological and general medical examinations.
Axial length as a surrogate for myopia and prevalence of diabetic retinopathy (DR), age-related macular degeneration (AMD), angle-closure glaucoma (ACG), and open-angle glaucoma (OAG).
In the UEMS, DR prevalence (odds ratio [OR], 0.73), AMD prevalence (OR, 0.85), and ACG prevalence (OR, 0.72) decreased, and OAG prevalence (OR, 1.65) increased with longer axial length in multivariable analyses. In the CIEMS, lower AMD prevalence (OR, 0.81) and lower ACG prevalence (OR, 0.55), and higher OAG prevalence (OR, 1.45) were associated with longer axial length. Diabetic retinopathy prevalence (0.33%) was too low for statistical analysis in the CIEMS. In the BES, prevalence (OR, 0.64) and 10-year incidence of DR (OR, 0.48) and prevalence (OR, 0.83) and 5-year incidence of AMD (OR, 0.996) decreased, and prevalence (OR, 1.35) and 10-year incidence of OAG (OR, 1.40) increased with longer axial length. In all 3 studies, the association between higher OAG prevalence and longer axial length was nonlinear with a slight increase for the moderate myopia range and a steep increase in the highly myopic range.
Myopia is associated with a lower prevalence of DR, AMD, and ACG and a lower incidence of DR and AMD, whereas high myopia more than moderate myopia is associated with a higher prevalence and incidence of OAG. Future studies may assess whether in myopia (in particular, in moderate myopia), the myopia-related advantages, that is, lower prevalence of DR, AMD, and ACG, may outweigh the increased risks for OAG and other myopia-related disorders.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
近视以及由近视性黄斑病变和近视相关视神经病变导致的视力损害的患病率在全球范围内显著增加。我们评估了近视是否与其他眼部疾病有关。
在俄罗斯、中国和印度进行的基于人群的研究。
俄罗斯乌拉尔眼科和医学研究（UEMS）和北京眼科研究（BES）分别纳入了 5899 名和 4439 名（均为 40 岁以上）参与者，而中央印度眼科和医学研究（CIEMS）则纳入了 4711 名 30 岁以上的参与者。这些研究在俄罗斯巴什科尔托斯坦的农村和城市地区、印度那格浦尔和中国北京进行。
参与者接受了一系列眼科和一般医学检查。
眼轴长度作为近视的替代指标，以及糖尿病视网膜病变（DR）、年龄相关性黄斑变性（AMD）、闭角型青光眼（ACG）和开角型青光眼（OAG）的患病率。
在 UEMS 中，多变量分析显示，DR 患病率（比值比[OR]，0.73）、AMD 患病率（OR，0.85）和 ACG 患病率（OR，0.72）下降，而 OAG 患病率（OR，1.65）增加与眼轴长度增加有关。在 CIEMS 中，较低的 AMD 患病率（OR，0.81）和 ACG 患病率（OR，0.55），以及较高的 OAG 患病率（OR，1.45）与眼轴长度增加有关。CIEMS 中 DR 的患病率（0.33%）过低，无法进行统计学分析。在 BES 中，DR 的患病率（OR，0.64）和 10 年发病率（OR，0.48）以及 AMD 的患病率（OR，0.83）和 5 年发病率（OR，0.996）下降，而 OAG 的患病率（OR，1.35）和 10 年发病率（OR，1.40）增加与眼轴长度增加有关。在所有 3 项研究中，较高的 OAG 患病率与较长的眼轴长度之间的关联是非线性的，中度近视范围略有增加，高度近视范围急剧增加。
近视与 DR、AMD 和 ACG 的患病率较低以及 DR 和 AMD 的发病率较低有关，而高度近视比中度近视与 OAG 和其他近视相关疾病的患病率和发病率增加有关。未来的研究可能会评估在近视（特别是中度近视）中，与近视相关的优势，即 DR、AMD 和 ACG 的患病率较低，是否超过 OAG 和其他近视相关疾病的风险增加。
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