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  • High Myopia and Glaucoma Risk in Beijing Eye Study

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    British Journal of Ophthalmology
    Published online Feb. 22, 2022

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    Little is known about the long-term in­cidence of and risk factors for open-an­gle glaucoma (OAG) among Chinese people. Moreover, previous longitudi­nal studies in China and elsewhere had limitations such as timelines of just five years. Wang et al. aimed to learn more through an observational analysis of data from the 10-year Beijing Eye Study. They found high myopia to be a major risk factor for OAG.

    Of the 4,439 participants aged 40 and older in the Beijing Eye Study at its inception in 2001, 2,695 (60.7%) were available for examination in 2011. Assessments included measuring IOP, vertical cup-to-disc ratio (VCDR), and uncorrected visual acuity; performing automatic refractometry; viewing the anterior segment by slit lamp; and im­aging the macula and optic nerve head. Ocular biometry was used to measure central corneal thickness (CCT), corne­al curvature radius, anterior chamber depth, lens thickness, and total axial length. IOP readings were corrected for dependence on CCT and central corneal curvature radius using linear regression analysis. Demographic data, risk factors, and OAG incidence were documented. Incident glaucoma was defined as the absence of glaucoma at baseline with observation of structur­al glaucomatous changes in the optic nerve head and retinal nerve fiber layer in 2011. Refractive status was classified as emmetropia/hyperopia, minor myo­pia, moderate myopia, or high myopia based on respective axial lengths of <24 mm, 24-25 mm, 25.01-26 mm, and >26 mm.

    Incident glaucoma was found in 75 of the 2,494 participants who did not have it at baseline. The 10-year inci­dence of OAG ranged from 1.8% for participants in their 40s to 5.9% for those older than 69 years (mean, 3.0%) and was greatest for those with high myopia (odds ratio [OR], 7.3), followed by moderate myopia (OR, 4.2) and low myopia (OR, 3.2). In the multivariable analysis, OAG was linked to older age (OR, 1.06), longer axial length (OR, 1.72), higher IOP in 2001 (OR, 1.18), higher VCDR (OR, 60.8), and thinner CCT (OR, 0.98). OAG was more com­mon in men, but the gender difference was not significant.

    The greatest risk factor for OAG in this analysis was high myopia; compared with emmetropic eyes, the risk was more than sevenfold. These findings may be relevant for clinical protocols and screening strategies, said the authors.

    The original article can be found here.