Elsevier

Ophthalmology

Volume 106, Issue 10, 1 October 1999, Pages 2010-2015
Ophthalmology

The relationship between glaucoma and myopia: The blue mountains eye study

https://doi.org/10.1016/S0161-6420(99)90416-5Get rights and content

Abstract

Objective

To quantify the relationship between myopia and open-angle glaucoma, ocular hypertension (OH), and intraocular pressure (IOP) in a representative older population.

Design

Cross-sectional population-based study of 3654 Australians 49 to 97 years of age.

Methods

Subjects with any myopia (≥−1.0 diopter [D]) were identified by a standardized subjective refraction and categorized into low myopia (≥−1.0 D to <−3.0 D) or moderate-to-high myopia (≥−3.0 D). Glaucoma was diagnosed from characteristic visual field loss, combined with optic disc cupping and rim thinning, without reference to IOP. Ocular hypertension was diagnosed when applanation IOP was greater than 21 mmHg in either eye in the absence of glaucomatous visual field and optic disc changes.

Main outcome measure

General estimating equation models were used to assess associations between eyes with myopia and either glaucoma or OH.

Results

Glaucoma was present in 4.2% of eyes with low myopia and 4.4% of eyes with moderate-to-high myopia compared to 1.5% of eyes without myopia. The relationship between glaucoma and myopia was maintained after adjusting for known glaucoma risk factors, odds ratio (OR) of 2.3, and 95% confidence intervals (CI) of 1.3 to 4.1 for low myopia. It was stronger for eyes with moderate-to-high myopia (OR, 3.3; CI, 1.7–6.4). Only a borderline relationship was found with OH, OR of 1.8 (CI, 1.2–2.9) for low myopia, and OR of 0.9 (CI, 0.4–2.0) for moderate-to-high myopia. Mean IOP was approximately 0.5 mmHg higher in myopic eyes compared to nonmyopic eyes.

Conclusions

This study has confirmed a strong relationship between myopia and glaucoma. Myopic subjects had a twofold to threefold increased risk of glaucoma compared with that of nonmyopic subjects. The risk was independent of other glaucoma risk factors and IOP.

Section snippets

Methods

The Blue Mountains Eye Study is a population-based survey of age-related eye diseases in residents of an urban population in the Blue Mountains region, west of Sydney, Australia. Survey methods were described previously.24, 26, 27 All permanent noninstitutionalized residents 49 years of age or older were identified in a door-to-door census. Of 4433 eligible residents, 3654 (82.4%) were examined from 1992 to 1994. After excluding persons who died or left the area during the survey and could not

Results

Definite or probable glaucoma was diagnosed in 108 persons (3%); the prevalence increased exponentially with age.24 Among persons diagnosed with glaucoma, 72 (66.7%) had typical glaucomatous field loss in the right eye and 88 (81.5%) had field loss in the left eye (total, 160 eyes). After nonphakic eyes were excluded, a total of 126 eyes had diagnostic glaucomatous field loss and could be used for analysis. The OH was found in 135 participants, a prevalence of 3.7% (CI, 3.1–4.3) but with no

Discussion

This population-based study of an Australian white community has found a strong relationship between open-angle glaucoma and myopia, after taking into account the effects of other known glaucoma risk factors. This association was present for eyes with low myopia (OR, 2.3) and was stronger (OR, 3.3) for eyes with moderate-to-high myopia, suggesting a dose response. The consistency of these findings provides support for the hypothesis of a true relationship between the two conditions.

It may be

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  • Cited by (0)

    Supported by the Australian Department of Health and Family Services and the Save Sight Institute, University of Sydney, Sydney, Australia.

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