High Myopia-Induced Optic Nerve Head Deformation and Glaucoma Progression: A Three-Year Follow-Up Study.

IF 4.7 2区医学 Q1 OPHTHALMOLOGY

Investigative ophthalmology & visual science Pub Date : 2025-10-01 DOI:10.1167/iovs.66.13.30

Jinyue Dai, Xiaofei Wang, YingXiang Han, Cancan Xue, XuRan Dong, Ke Zhang, Haocheng Xian, WeiJia Zhang, Chun Zhang, Jing Hong

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引用次数: 0

Abstract

Purpose: To investigate the biomechanical effects of high myopia (HM)-related optic nerve head (ONH) structural changes on glaucoma progression and identify key predictive parameters.

Methods: This prospective cohort study enrolled 242 eyes: 97 highly myopic glaucoma (HMG), axial length > 26.5 mm; 145 open-angle glaucoma (OAG), axial length ≤ 26.5 mm. ONH parameters, including Bruch's membrane opening (BMO), anterior scleral canal opening (ASCO) areas, neural canal minimum cross-sectional area (NCMCA), and ASCO-BMO offset, were quantified via spectral-domain OCT. Visual field (VF) defects and parapapillary retinal nerve fiber layer (pRNFL) thickness were monitored over 3 years. Generalized linear mixed models and multivariate regression were used for analysis.

Results: Compared with OAG, HMG eyes exhibited larger BMO areas (3.0 vs. 2.3 mm2, P < 0.001) and ASCO areas (2.6 vs. 2.4 mm2, P < 0.001), greater ASCO-BMO offset (376.1 vs. 161.5 µm, P < 0.001), smaller NCMCA (1.0 vs. 1.3 mm2, P < 0.001), and faster temporal VF progression (0.173 vs. 0.060 dB/y, P = 0.023) and pRNFL thinning (0.96 vs. 0.64 µm/y, P = 0.014). Multivariate analysis identified NCMCA as an independent predictor of global progression (β = -0.03, P = 0.021).

Conclusions: HM-induced ONH deformation, particularly nasal tilting and reduced NCMCA, accelerates temporal glaucomatous damage. NCMCA serves as a critical biomarker for progression risk, supporting individualized management in glaucoma with HM.

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高度近视引起的视神经头变形和青光眼进展：一项三年随访研究。

目的：探讨高度近视（HM）相关视神经头（ONH）结构改变对青光眼进展的生物力学影响，并确定关键预测参数。方法：本前瞻性队列研究纳入242只眼：高度近视青光眼（HMG） 97只，眼轴长> 26.5 mm；145开角型青光眼（OAG），眼轴长度≤26.5 mm。ONH参数包括Bruch膜开口（BMO）、巩膜前管开口（ASCO）面积、神经管最小横截面积（NCMCA）和ASCO-BMO偏移量，通过光谱域oct进行量化，监测视野（VF）缺损和视网膜乳头旁神经纤维层（pRNFL）厚度3年。采用广义线性混合模型和多元回归进行分析。结果：与OAG相比，HMG眼睛BMO面积（3.0 vs. 2.3 mm2, P < 0.001）和ASCO面积（2.6 vs. 2.4 mm2, P < 0.001）较大，ASCO-BMO偏移量（376.1 vs. 161.5µm, P < 0.001）较大，NCMCA较小（1.0 vs. 1.3 mm2, P < 0.001），颞部VF进展较快（0.173 vs. 0.060 dB/y, P = 0.023）， pRNFL变薄（0.96 vs. 0.64µm/y, P = 0.014）。多变量分析表明NCMCA是全局进展的独立预测因子（β = -0.03, P = 0.021）。结论：hm诱导的ONH变形，特别是鼻部倾斜和NCMCA降低，加速了颞部青光眼的损害。NCMCA作为进展风险的关键生物标志物，支持HM青光眼的个体化治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Investigative ophthalmology & visual science 医学-眼科学

CiteScore

6.90

自引率

4.50%

发文量

339

审稿时长

1 months

期刊介绍： Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.