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Degree of myopia and glaucoma risk: a dose-response meta-analysis


The purpose of the study was to verify the dose-response relation between the degree of myopia and open-angle glaucoma ( OAG ) risk, conducting a dose-response meta-analysis.

The search has concerned population-based studies published until November 30, 2020, and reporting on both myopia and open-angle glaucoma.
A 2-stage dose-response meta-analysis calculated the open-angle glaucoma risk per unit dose of myopia ( spherical equivalent [ SE ] decrease of 1 diopter [ D ] ) and examined the relationship pattern.

The meta-analysis comprised 24 studies in 11 countries ( 514,265 individuals ).

The pooled odds ratio ( OR ) of any myopia degree's association with open-angle glaucoma was 1.88 ( 95% CI, 1.66-2.13; I2 = 53% ).

The OR differences based on ethnicity ( Asians vs Westerners ) or 5 geographic areas were not statistically significant ( P = 0.80 and P = 0.06, respectively ).

The pooled odds ratios of the associations between low, moderate, moderate-to-high, high myopia, and open-angle glaucoma were 1.50 ( 95% CI, 1.29-1.76 ), 1.69 ( 95% CI, 1.33-2.15 ), 2.27 ( 95% CI, 1.74-2.96 ), and 4.14 ( 95% CI, 2.57-6.69 ), respectively.

According to the dose-response meta-analysis, the pooled odds ratio ( per SE 1-D change ) was 1.21 ( 95% CI, 1.15-1.28 ).
The open-angle glaucoma risk accelerated at approximately -6 D, and further accelerated from -8 D, showing a nonlinear concave upward slope ( P =0 .03 ).

In conclusion, for each unit ( 1-D ) increase in myopia, the risk of glaucoma has increased by approximately 20%.
The risk more steeply has increased in high-degree myopia, representing a significant nonlinear relationship. ( Xagena )

Ha A et al, Am J Ophthalmol 2021; 236: 107-119

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