Aims To investigate any association between intraocular pressure (IOP) reduction amount and open-angle glaucoma (OAG) progression in highly myopic eyes and to determine the associated risk factors. Methods One hundred and thirty-one (131) eyes of 131 patients with highly myopic OAG, all of whom had received topical medications and been followed for 5 years or longer, were enrolled. Based on the IOP reduction percentage, patients were categorised into tertile groups, and subsequently, the upper-tertile and lower-tertile groups were compared for the cumulative probability of glaucoma progression. Kaplan-Meier survival analysis and log-rank testing were applied in the comparison, and multivariate analysis with Cox’s proportional hazard model, additionally, was performed to identify progression risk factors. Results Throughout the average 11.6±4.4 year follow-up on the 131 eyes (mean age, 41.2 years at initial visit; baseline IOP, 16.4 mm Hg), 72 eyes (55.0%) showed glaucoma progression. The upper-tertile group (IOP reduction percentage>23.7%) showed a high cumulative probability of non-progression relative to the lower-tertile group (IOP reduction percentage<11.0%; p=0.034), according to the Kaplan-Meier analysis. Presence of disc haemorrhage (DH; HR=2.189; p=0.032) was determined by the multivariate Cox’s proportional hazard model to be significantly associated with glaucoma progression. For progressors, the average rate of retinal nerve fibre layer thickness thinning was −0.88±0.74 µm/year, while the MD change was −0.42±0.36 dB/year. Conclusions Glaucoma progression is associated with amount of IOP reduction by topical medications in highly myopic eyes, and DH occurrence is a glaucoma progression risk factor. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

---

眼压降低和高度近视青光眼的进展：一项 12 年随访队列研究


目的 研究高度近视眼眼压 (IOP) 降低量与开角型青光眼 (OAG) 进展之间的关联，并确定相关危险因素。方法 纳入 131 名高度近视 OAG 患者的一百三十一 (131) 只眼，所有患者均接受过局部药物治疗并随访 5 年或更长时间。根据眼压下降百分比，将患者分为三分位组，随后比较上三分位组和下三分位组的青光眼进展的累积概率。在比较中应用了Kaplan-Meier生存分析和对数秩检验，并使用Cox比例风险模型进行多变量分析，以确定进展危险因素。结果 在对 131 只眼睛（平均年龄，初次就诊时 41.2 岁；基线眼压，16.4 mm Hg）进行的平均 11.6±4.4 年随访中，72 只眼睛（55.0%）出现青光眼进展。根据 Kaplan-Meier 分析，相对于下三分位组（IOP 降低百分比<11.0%；p=0.034），上三分位组（IOP 降低百分比>23.7%）表现出较高的累积无进展概率。通过多变量 Cox 比例风险模型确定椎间盘出血（DH；HR=2.189；p=0.032）的存在与青光眼进展显着相关。对于进展者，视网膜神经纤维层厚度变薄的平均率为-0.88±0.74 µm/年，而MD变化为-0.42±0.36 dB/年。结论 青光眼进展与高度近视眼局部药物降低眼压的量有关，DH 的发生是青光眼进展的危险因素。 与研究相关的所有数据都包含在文章中或作为补充信息上传。