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Intraocular pressure reduction and progression of highly myopic glaucoma: a 12-year follow-up cohort study
  1. Young In Shin1,2,
  2. Young Kook Kim1,2,
  3. Jin Wook Jeoung1,2,
  4. Ki Ho Park1,2
  1. 1Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
  2. 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
  1. Correspondence to Professor Ki Ho Park, Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of); kihopark{at}snu.ac.kr

Abstract

Aims To investigate any association between intraocular pressure (IOP) reduction amount and open-angle glaucoma (OAG) progression in highly myopic eyes and to determine the associated risk factors.

Methods One hundred and thirty-one (131) eyes of 131 patients with highly myopic OAG, all of whom had received topical medications and been followed for 5 years or longer, were enrolled. Based on the IOP reduction percentage, patients were categorised into tertile groups, and subsequently, the upper-tertile and lower-tertile groups were compared for the cumulative probability of glaucoma progression. Kaplan-Meier survival analysis and log-rank testing were applied in the comparison, and multivariate analysis with Cox’s proportional hazard model, additionally, was performed to identify progression risk factors.

Results Throughout the average 11.6±4.4 year follow-up on the 131 eyes (mean age, 41.2 years at initial visit; baseline IOP, 16.4 mm Hg), 72 eyes (55.0%) showed glaucoma progression. The upper-tertile group (IOP reduction percentage>23.7%) showed a high cumulative probability of non-progression relative to the lower-tertile group (IOP reduction percentage<11.0%; p=0.034), according to the Kaplan-Meier analysis. Presence of disc haemorrhage (DH; HR=2.189; p=0.032) was determined by the multivariate Cox’s proportional hazard model to be significantly associated with glaucoma progression. For progressors, the average rate of retinal nerve fibre layer thickness thinning was −0.88±0.74 µm/year, while the MD change was −0.42±0.36 dB/year.

Conclusions Glaucoma progression is associated with amount of IOP reduction by topical medications in highly myopic eyes, and DH occurrence is a glaucoma progression risk factor.

  • intraocular pressure
  • glaucoma
  • treatment medical

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Correction notice This paper has been corrected since it was first published. The ethics statement was inadvertently omitted during the production process and it has now been reinstated.

  • Contributors Guarantor: KHP. Conception and design: YIS and KHP. Acquisition, analysis, or interpretation of data: YIS, JWJ and YKK. Statistical analysis: YIS. Drafting of the manuscript and final approval of the version: all authors. Revision of the manuscript for important intellectual content: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.