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Abstract

Background : Primary open-angle glaucoma (POAG) ranks among the leading irreversible causes of blindness worldwide. Emerging data suggest that eyes with pronounced axial myopia (spherical equivalent ≤ –6.00 D) are more prone to POAG, yet the precise magnitude of this risk and the ocular changes that mediate it remain uncertain.
Objectives:  To quantify the likelihood of POAG in adults aged 40 years and older with high myopia and to assess whether axial length, intraocular pressure (IOP), vertical cup-to-disc ratio (VCDR), central corneal thickness (CCT), and visual-field mean deviation (VF-MD) help explain that association.
Methods:  We retrospectively reviewed n=150 consecutive records: n=75 highly myopic eyes and n=75 emmetropic or mildly myopic controls. Each patient underwent a complete ophthalmic work-up, including refraction, axial-length measurement, tonometry, optic-disc evaluation, pachymetry, and standard automated perimetry. POAG was diagnosed by the International Society of Geographical and Epidemiological Ophthalmology criteria. Crude and adjusted odds ratios (ORs) were derived with logistic regression, and Pearson coefficients explored inter-relations among ocular metrics in the myopic subgroup.
Results : Compared with controls, highly myopic eyes exhibited longer axial lengths, more negative refractive errors, higher IOP, larger VCDR values, and more severe VF-MD loss (all p < 0.01). POAG prevalence was 30.7 % in the myopia group versus 10.7 % in controls (p < 0.001). After adjustment for age, sex, ethnicity, and other covariates, high myopia remained an independent risk factor for POAG (adjusted OR = 3.45; 95 % CI 1.52–7.82; p = 0.003). Within the myopic cohort, IOP correlated positively with VCDR (r = 0.42; p = 0.001), while axial length correlated inversely with spherical equivalent (r = –0.75; p < 0.001).
Conclusion:  Marked axial myopia independently heightens the risk of POAG. Vigilant screening and earlier intervention in this high-risk group are warranted.