Early glaucoma risk factors in myopia

Aim. To reveal early glaucoma diagnostic criteria in high-degree axial myopia based on the morphometric analysis of the retina and optic nerve.

Materials and methods. Standard ophthalmic exam, OCT of the retina and optic nerve as well as macular pigment optical density (MPOD) measurements were performed in three cohorts of patients with axial myopia (normal IOP, glaucoma, ocular hypertension / OHT). In OHT group, the data obtained were analyzed by the parameters for which significant differences between normal IOP and glaucoma cohorts were demonstrated.

Results. Significant differences were identified between study (axial myopia and OHT) and control group (axial myopia and normal IOP) by the following parameters: 1) IOP measured by pneumotonometry (20.5±3.1 vs 13.3±0.8 mm Hg, respectively); 2) corneal-compensated IOP estimated by Ehlers based on 5‑g Maklakov applanation tonometry
(19.1±2.8 vs 15.1±1.0 mm Hg, respectively); 3) ganglion cell complex and inner plexiform layer thickness in the superior macular region (73.4±7.0 vs 81.0±3.2 μm, respectively); 4) retinal nerve fiber layer thickness in the inferior peripapillary area (99.6±14.9 vs 121.9±9.4 μm, respectively); 5) choroidea thickness in foveal center (258.1±48.1 vs 315.8±29.5 μm, respectively) and 3 mm nasally to foveal center (130.0±32.1 vs 161.0±29.8 μm, respectively).

Conclusion. It is reasonably to isolate axial myopia and OHT patients into glaucoma high-risk group that requires careful dynamic follow-up and therapy correction. Glaucoma diagnostic criteria should be also revaluated as the possibilities of modern diagnostic base and its resolution increase.

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