Ma Wei, Li Xinyi, Xie Liqing, Jiang Feng, He Mingguang, Wang Decai, Li Zhixi
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, People's Republic of China.
Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong, People's Republic of China.
Transl Vis Sci Technol. 2025 Sep 2;14(9):12. doi: 10.1167/tvst.14.9.12.
The purpose of this study was to estimate the correlations between macular optical coherence tomography (OCT)-derived metrics and incident glaucoma risk in myopic eyes.
This longitudinal observational study included 24,181 individuals with myopia (spherical equivalence [SE] ≤ -0.5 diopters [D]) from the UK Biobank study.
Participants (mean age = 55.5 ± 8.0 years, 54.5% women) were followed up for 13.2 ± 1.2 years and incident glaucoma was diagnosed in 582 eyes. Those who developed glaucoma were significantly older (P < 0.001), more likely to be male participants (P < 0.001), and had more pronounced myopic refractive error (P < 0.001). Cox regression analyses indicated that participants with thinner retinal nerve fiber layer (RNFL; hazard ratio [HR] = 0.97, 95% confidence interval [CI] = 0.96-0.99, P < 0.001), thinner ganglion cell-inner plexiform layer (GCIPL; HR = 0.97, 95% CI = 0.96-0.98, P < 0.001), and thinner ganglion cell complex (GCC; HR = 0.98, 95% CI = 0.97-0.99, P < 0.001) had an increasing risk of incident glaucoma after adjustment for age, sex, ethnic group, and SE. Meanwhile, the thicker inner nuclear layer (INL; HR = 1.03, 95% CI = 1.01-1.05, P = 0.002) and photoreceptor segments (PS; HR = 1.03, 95% CI = 1.01-1.06, P = 0.024) were positive for the incidence of glaucoma.
This longitudinal study suggested that baseline RNFL, GCIPL, GCC, INL, and PS thickness were significant predictors for the incidence of glaucoma among myopic participants, which indicated a pattern of internal layer thinning (except INL) and outer layer thickening in these pre-glaucoma participants.
Our study highlighted the potential of OCT-derived indicators for early glaucoma risk assessment and clinical monitoring.
本研究旨在评估黄斑光学相干断层扫描（OCT）衍生指标与近视眼中青光眼发病风险之间的相关性。
这项纵向观察性研究纳入了英国生物银行研究中的24181名近视患者（等效球镜度[SE]≤-0.5屈光度[D]）。
参与者（平均年龄=55.5±8.0岁，54.5%为女性）随访13.2±1.2年，582只眼被诊断为青光眼。发生青光眼的患者年龄显著更大（P<0.001），男性参与者更常见（P<0.001），近视屈光不正更明显（P<0.001）。Cox回归分析表明，在调整年龄、性别、种族和SE后，视网膜神经纤维层（RNFL）较薄（风险比[HR]=0.97，95%置信区间[CI]=0.96-0.99，P<0.001）、神经节细胞-内丛状层（GCIPL）较薄（HR=0.97，95%CI=0.96-0.98，P<0.001）和神经节细胞复合体（GCC）较薄（HR=0.98，95%CI=0.97-0.99，P<0.001）的参与者发生青光眼的风险增加。同时，内核层（INL）较厚（HR=1.03，95%CI=1.01-1.05，P=0.002）和光感受器节段（PS）较厚（HR=1.03，95%CI=1.01-1.06，P=0.024）与青光眼的发病呈正相关。
这项纵向研究表明，基线RNFL、GCIPL、GCC、INL和PS厚度是近视参与者中青光眼发病的重要预测指标，这表明这些青光眼前期参与者存在内层变薄（INL除外）和外层增厚的模式。
我们的研究突出了OCT衍生指标在早期青光眼风险评估和临床监测中的潜力。
