Duration 5min, Q&A 3min
Diagnosis and Management of Glaucoma in Myopic Eyes
To develop the algorithm of diagnosis and management of glaucoma in myopic eyes.
17 patients (33 eyes) aged from 21 to 76 years old with axial myopia (axial length from 25,3 mm to 30,5 mm) were divided into two groups. The first group included 6 patients (11 eyes) with myopia and primary open-angle glaucoma (POAG) (glaucoma group). The second group included 11 patients (22 eyes) with high myopia without POAG (control group).
All participants underwent through the standard ophthalmological examination. Intraocular pressure (IOP) was measured by applanation tonometer (weight 5 g). Ehlers correction factor was calculated using central corneal thickness data. In addition the macular pigment optical density (MPOD) (Tinsley Precision Insruments, Ltd, UK) and optical coherence tomography (OCT) (Cirrus HD-OCT 4000, CARL ZEISS MEDITEC), was carried out. OCT selected protocols were: measurement of ganglion cell complex and inner plexiform layer (GCC+IPL), optical nerve head (ONH) parameters, retinal nerve fiber layer (RNFL), choroid thickness.
Results and Conclusion
After the comparison of all the possible options, we decided to present only statistically significant data (p<0,01). Applanation IOP was 19,4±3,8 mm Hg (Ehlers correction IOP 19,3±2,1 mm Hg) in the glaucoma group and 14,9±0,9 mm Hg (Ehlers correction IOP 15,1±0,6 mm Hg) in the control group. Average GCC+IPL was 67,8±8,5 µm (minimum GCC+IPL 50,8±13,6 µm) in the glaucoma group and 80,1±3,4 µm (75,5±5,8 µm) in the control group. Rim area and average RNFL in the glaucoma and the control groups were 1,14±0,2 mm2 , 74,6±8,1 µm and 1,32±0,1 mm2 , 89,9±3,5 µm respectively. Choroid thickness 3 mm nasal from the fovea center was 70,0±18,2 µm (subfoveal choroid thickness 159,3±40,6 µm) and 168,3±33,4 µm (327,4±31,1 µm) in the glaucoma and the control groups accordingly. MPOD in the glaucoma and the control groups was 0,26±0,02 and 0,34±0,04 respectively.
Thus our algorithm of diagnosis and management of glaucoma in myopic eyes includes except of standard ophthalmological examination: 1) applanation tonometry (weight 5 g), 2) central corneal thickness measurement, 3) Ehlers correction factor calculation, 4) OCT of the ONH, peripapillary area, macular area and choroid, 5) MPOD measurement. Usage of this algorithm will allow us to find preclinical signs of glaucoma progression in myopic eyes as well as to define the tolerant IOP.
[ Keyword ]
glaucoma, myopia, diagnosis, OCT, IOP
[ Conflict of Interest ]