Elsevier

Ophthalmology

Volume 118, Issue 10, October 2011, Pages 1989-1994.e2
Ophthalmology

Original article
Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis

https://doi.org/10.1016/j.ophtha.2011.03.012Get rights and content

Objective

To determine the association between myopia and open-angle glaucoma.

Design

Systematic review and meta-analysis of observational studies.

Participants

Thirteen studies involving 48 161 individuals.

Methods

Articles published between 1994 and 2010 were identified in PubMed, Embase, and reference lists. Study-specific odds ratios (ORs) were pooled using a random effects model.

Main Outcome Measures

Odds ratios with 95% confidence intervals (CIs) of myopia as a risk factor for open-angle glaucoma.

Results

Data from 11 population-based cross-sectional studies were included in the main analyses. The pooled OR of the association between myopia and glaucoma based on 11 risk estimates was 1.92 (95% CI, 1.54–2.38). On the basis of 7 risk estimates, the pooled ORs of the associations between low myopia (myopia up to −3 D) and glaucoma and between high myopia (≤−3 D myopic) and glaucoma were 1.65 (1.26–2.17) and 2.46 (1.93–3.15), respectively. There was considerable heterogeneity among studies that reported an association between any myopia and glaucoma (I2=53%) and low myopia and glaucoma (I2=29%), but not for high myopia and glaucoma (I2=0%). After omitting studies that contributed significantly to the heterogeneity, the pooled ORs were 1.88 (1.60–2.20) for any myopia and glaucoma and 1.77 (1.41–2.23) for low myopia and glaucoma.

Conclusions

Individuals with myopia have an increased risk of developing open-angle glaucoma.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Search Strategy

Two of the authors (MMV and FGJM) independently conducted a systematic search of PubMed and Embase up to October 27, 2010, in accordance with the MOOSE consensus statement.19 The search terms used in PubMed included (“myopia”[MeSH Terms] OR “myopia”[All Fields]) OR myopic[All Fields] OR (“refractive errors”[MeSH Terms] OR (“refractive”[All Fields] AND “errors”[All Fields]) OR “refractive errors”[All Fields] OR (“refractive”[All Fields] AND “error”[All Fields]) OR “refractive error”[All

Results

Figure 1 shows the selection process. The literature search yielded 1176 articles, 527 from PubMed and 649 from Embase, of which 70 were reviewed in full text. After a thorough review, 13 studies met the inclusion criteria for this meta-analysis.21, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38 All studies were population based: 11 cross-sectional,28, 29, 30, 31, 32, 33, 34, 35, 36, 37 1 case-control,27 and 1 longitudinal cohort study.38 Six studies were conducted in Asia,21, 32, 33, 34, 35, 36

Discussion

The findings from this meta-analysis indicate that individuals with myopia have an approximately doubled risk of developing OAG in comparison with individuals without myopia. The pooled ORs were 2.46 (95% CI, 1.93–3.15) for high myopia and 1.77 (95% CI, 1.41–2.23) for low myopia, with a cutoff value of −3 D.

Although the point estimate of the pooled OR of high myopia was larger than that of low myopia, the difference was small. A more pronounced dose-response relationship would have reinforced

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    Manuscript no. 2010-1656.

    Funding: This research was supported by the University Medical Center Groningen, stichting Nederlands oogheelkundig onderzoek, algemene Nederlandse vereniging ter voorkoming van blindheid, oogfonds, glaucoomfonds, and stichting blindenhulp, all in The Netherlands. The funding organizations had no role in the design, conduct, analysis or publication of this research.

    Financial Disclosure(s): The author (s) have no proprietary or commercial interest in any materials discussed in this article.

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