State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, China.
Invest Ophthalmol Vis Sci. 2024 Aug 1;65(10):43. doi: 10.1167/iovs.65.10.43.
To investigate the long-term patterns and risk factors of visual field defect (VFD) development in nonpathologic high myopia (HM) over an 8-year follow-up.
This was an observational cohort study. The VFD classification adhered to the Glaucoma Suspects with High Myopia Study Group. Logistic regression models with generalized estimating equations were used to identify risk factors for VFD development.
A total of 330 eyes from 194 patients were included. Among them, 49.4% of eyes developed VFD, with enlarged blind spot and nonspecific defect ranked as the most common VFDs, followed by partial arcuate defect, vertical step, nasal step, paracentral defect, and combined defects. Longer axial length (odds ratio [OR] = 1.43 per 1-mm increase; 95% CI, 1.04-1.95; P = 0.026), thinner central corneal thickness (OR = 1.01 per 1-µm decrease; 95% CI, 1.003-1.02; P = 0.013), worse mean deviation of visual field (OR = 1.51 per 1-dB decrease; 95% CI, 1.14-2.00; P = 0.004), and the presence of peripapillary γ-zone (OR = 5.57; 95% CI, 3.06-10.15; P < 0.001) at baseline correlated with the development of any VFD. By incorporating these factors, the prediction models achieved area under the curves of 0.789 (95% CI, 0.726-0.853) and 0.828 (95% CI, 0.714-0.943) for discriminating the development of any VFD and moderate/severe VFD, respectively, with good calibration power.
The development of VFD occurred frequently in individuals with nonpathologic HM and can be effectively predicted using relevant metrics. The findings will aid in expanding our knowledge of optic neuropathy in HM.
通过 8 年的随访，研究非病理性高度近视（HM）患者的视野缺损（VFD）发展的长期模式和危险因素。
这是一项观察性队列研究。VFD 分类遵循青光眼疑似高度近视研究组的标准。使用广义估计方程的逻辑回归模型来确定 VFD 发展的危险因素。
共纳入 194 例患者的 330 只眼。其中，49.4%的眼发生了 VFD，最常见的 VFD 为扩大的盲点和非特异性缺陷，其次为部分弓形缺陷、垂直阶梯、鼻阶梯、旁中心缺陷和联合缺陷。眼轴较长（优势比[OR]每增加 1mm 增加 1.43；95%CI，1.04-1.95；P=0.026）、中央角膜厚度较薄（OR=每减少 1μm 增加 1.01；95%CI，1.003-1.02；P=0.013）、视野平均偏差较差（OR=每减少 1dB 增加 1.51；95%CI，1.14-2.00；P=0.004）以及基线时存在视盘旁γ 带（OR=5.57；95%CI，3.06-10.15；P<0.001）与任何 VFD 的发展相关。纳入这些因素后，预测模型对任何 VFD 和中重度 VFD 的发展的曲线下面积分别为 0.789（95%CI，0.726-0.853）和 0.828（95%CI，0.714-0.943），具有良好的校准能力。
非病理性 HM 患者的 VFD 发生率较高，可使用相关指标有效预测。这些发现将有助于我们加深对 HM 视神经病变的认识。
