This retrospective study of 131 eyes with high myopia (refraction >-6.0 dioptres or axial length >26mm), best corrected vision 20/40 or better, open angle and follow-up period of more than five years, were included from Korea. Based on the intraocular pressure (IOP) reduction percentage, patients were divided into tertile groups. The upper-tertile and the lower-tertile groups were analysed for the cumulative probability of glaucoma progression. The mean follow-up period was 11.6 years, mean age of 41.2 years, and baseline IOP was 16.4mmHg. Seventy-two eyes (55%) showed progression; the upper-tertile group (IOP reduction percentage of >23.7%) showed a high cumulative probability of non-progression relative to the lower-tertile group (IOP reduction percentage <11%). Presence of disc haemorrhage (DH) is significantly associated with glaucoma progression (p=0.012). For progression, the mean rate of retinal nerve fibre layer thickness thinning was -0.88um/year, and the MD change was -0.422dB/year. The authors concluded that glaucoma progression is associated with the amount of IOP reduction by topical medications in highly myopic eyes, and DH is a risk factor of glaucoma progression.
IOP reduction and progression of high myopic glaucoma
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