Myopia could be mistaken for glaucoma in some

A study published in the March issue of Ophthalmology, has found that many young and middle-aged people of Chinese ancestry who are told they have glaucoma may actually be misdiagnosed. These patients who do not show disease progression may, in fact, have glaucoma-like symptoms caused by myopia.

Amish Doshi, MD and colleagues from Stanford University, USA, observed more than 100 cases and fully reviewed the medical records of 16 Chinese men (average age 38.9 years) who had ocular symptoms suggestive of glaucoma. Average intraocular pressures (IOPs) ranged from 13.5 mmHg to 17.9 mmHg and 56.3% of subjects were using IOP-lowering medications.

Over a seven-year follow-up period, none of the subjects showed either progressive optic nerve cupping or visual field loss, regardless of whether they used anti-glaucoma medications.

Researchers discovered that 43.8% of eyes had myopia greater than 6 D, 75% of eyes had tilted discs and 81.3% of optic nerves had peripapillary atrophy. Cup-to-disc ratios averaged 0.56. The most common visual field defect was an arcuate defect, found in 31.3% of subjects.

The researchers believe that progressive myopia may have caused a strain gradient that affected susceptible axons in the preliminary optic nerve head tissue, leading to vision loss. The condition is now being studied in a larger population sample.