When We'' Suspect ""A Highly Myopic Patients Need to Start Glaucoma Medications

Abstract

Background:Globally, glaucoma is regarded as one of main causes of blindness that is irreversible in adults. One of major risk factors for primary open angle glaucoma (POAG) is raised intraocular pressure. Glaucoma is sometimes difficult to be diagnosed during early stages because of varying causes and multiple patterns of clinical presentation. Glaucoma is one of the complications that associate myopia, a disease of the eye that has both environmental and genetic bases.

Aim of the study:  The aim of this study is to focus on the findings implicating as indicators for beginning of glaucomatous changes in young myopic.

Patients and methods: this cohort study was carried out in Al-Diwaniyah province, mid-Euphrates region of Iraq,starting from April 2016 through June 2020. Forty five patients were enrolled in this study, a total of 78 eyes, with an age range of 4 to 20 years. The range of myopia spherical equivalent (SE) was ranging from (-6) to (-14) diopter. Patients were examined every 6 months for about 4 years and the clinical assessment included intraocular pressure (IOP), fundoscopy and visual field examination. The main objective was to make an idea about when to administer glaucoma medications to patients with high myopia when IOP measurement alone is not helping.

Results:B-zone atrophy, rim changes and nasalization of blood vessels were significantly associated with higher degree of myopia (P < 0.05), both individually and as a whole. B-zone atrophy was significantly associated with higher degree of myopia (P < 0.05); however, neither Rim changes nor Nasalization of blood vessels were significantly associated with higher degree of myopia, despite being more frequent (P> 0.05); however, taken all together fundoscopic changes were significantly associated with higher degree of myopia (P< 0.05).

Conclusions: It's more likely to initiate treatment in young myopes as progressive changes in the optic disc are noticed; because the patients with pathological myopia can't risk additional loss, on the other hand most of the eye examined had normal range intraocular pressure with an abnormal looking optic disc.