Clinicians may want to monitor macular ganglion cell–inner plexiform layer (GCIPL) thickness in their glaucoma patients to predict disease progression, even in individuals with high myopia, new research suggests.

The study enrolled 104 primary open-angle glaucoma (POAG) eyes with high myopia and 104 age- and visual field (VF) severity-matched POAG only eyes. Patients were followed up at about five years. The investigation defined high myopia as a spherical equivalent of less than -6.00D or an axial length of more than 26.5mm.

The researchers found highly myopic eyes with progressive GCIPL thinning had a significantly higher risk of developing VF progression after adjusting for baseline intraocular pressure (IOP) or peak IOP, while highly myopic eyes with progressive RNFL thinning were not significantly associated with VF progression.

In eyes without high myopia, both progressive GCIPL and RNFL thinning were associated with a significantly higher risk of developing VF progression after adjusting for baseline or peak IOP.

Shin JW, Song MK, Sung KR. Longitudinal macular ganglion cell–inner plexiform layer measurements to detect glaucoma progression in high myopia. American Journal of Ophthalmology. September 29, 2020. [Epub ahead of print].