Association between Nocturnal Blood Pressure Reduction and Progression of Visual Field Defect in Patients with Primary Open-Angle Glaucoma or Normal-Tension Glaucoma

Purpose To assess prospectively the relationship between nocturnal blood pressure reduction (dip) and progression of the visual field defect in patients with normal-tension glaucoma (NTG) or primary open-angle glaucoma (POAG).Patients and Methods The subjects studied were 38 patients with glaucoma (23 patients with NTG, 15 patients with POAG), in whom 48-h ambulatory blood pressure monitoring was conducted, who were followed for at least 4 years, and in whom reliable visual field tests were performed at least 5 times. The progression was determined by the mean deviation (MD) slope analysis system installed in the Humphrey field analyzer Statpac program. Glaucoma patients with a dip of <10% were assigned to the nondipper group, those with a dip of 10%–20% to the tipper group, and those with a dip of >20% to the extreme dipper group. The dipper group was defined as physiologic dippers, while the nondipper and the extreme dipper groups were defined as nonphysiologic dippers, to study the relationship between the disturbance of the dip and progression of the visual field defect.Results Thirteen patients showed significant progression, while 25 patients did not. There were no significant differences in the mean intraocular pressure and follow-up period between the patients with progression and those without progression. Half (7/14) of the nondippers, 20% (4/20) of the dippers, and 50% (2/4) of the extreme dippers showed progression, indicating a tendency of progression in the nondipper and the extreme dipper groups. The nonphysiologic dippers had a higher incidence of progression compared with the physiologic dippers (P = 0.05). Among the glaucoma patients in the nondipper and dipper categories only, those with progression had significantly smaller dips (P = 0.02).Conclusion These results suggest that disturbance in the physiologic dip may be involved in the progression of glaucoma. Jpn J Ophthalmol 2004;48:380–385 © Japanese Ophthalmological Society 2004     

Risk Factors Associated with Progression to Blindness from Primary Open-Angle Glaucoma in an African-American Population

Purpose: To determine the risk factors associated with progression to blindness from primary open-angle glaucoma (POAG) in an African-American population.

Methods: This study examined 2119 patients enrolled in the Primary Open-Angle African-American Glaucoma Genetics (POAAGG) study. A total of 59 eyes were identified as legally blind as a result of POAG (cases) and were age-and sex-matched to 59 non-blind eyes with glaucoma (controls). Chart reviews were performed to record known and suspected risk factors.

Results: Cases were diagnosed with POAG at an earlier age than controls (p = 0.005). Of the 59 eyes of cases, 16 eyes (27.1%) presented with blindness at diagnosis. Cases had worse visual acuity (VA) at diagnosis (p < 0.0001), with VA worse than 20/40 conferring a 27 times higher risk of progression to blindness (p = 0.0005). Blind eyes also demonstrated more visual field defects (p = 0.01), higher pre-treatment intraocular pressure (IOP; p < 0.0001), and higher cup-to-disc ratio (p = 0.006) at diagnosis. IOP was less controlled in cases, and those with IOP ≥21 mmHg at more than 20% of follow-up visits were 73 times more likely to become blind (p < 0.0001). Cases missed a greater number of appointments per year (p = 0.003) and had non-adherence issues noted in their charts more often than controls (p = 0.03). However, other compliance data did not significantly differ between groups.

Conclusion: Access to care, initial VA worse than 20/40, and poor control of IOP were the major risk factors associated with blindness from POAG. Future studies should examine earlier, more effective approaches to glaucoma screening as well as the role of genetics in these significantly younger patients who progress to blindness.     

Methylenetetrahydrofolate Reductase Genetic Polymorphisms in Patients with Primary Open-Angle Glaucoma

Purpose: Hyperhomocysteinemia has been found in patients with primary open-angle glaucoma. The purpose of the present study was to determine if hyperhomocysteinemia-associated polymorphisms of the methylenetetrahydrofolate reductase gene (MTHFR) are overrepresented in primary open-angle glaucoma. Methods: Patients with primary open-angle glaucoma (n = 243) and controls (n = 187) were analyzed for the MTHFR 677 C > T and 1298 A > C polymorphisms using minisequencing technique. Results: No significant differences were observed in allele and genotype frequencies of the MTHFR 677C > T and 1298A > C polymorphisms between controls and the primary open-angle glaucoma group. Conclusions: If hyperhomocysteinemia is important in the pathogenesis of glaucoma, this study does not support a role for MTHFR polymorphisms in this context.     

多焦视网膜电图在原发性开角型青光眼诊断中的应用

目的：探讨多焦视网膜电图（mfERG）技术用于诊断原发性开角型青光眼（POAG）的准确性及实效性。方法：系列病例研究。于2014 年10 月至2016 年3 月在云南省第一人民医院门诊就诊并确诊的POAG患者中随机选取60例（86眼）作为青光眼组,其中早、中、晚期组分别为20例（27眼）、20例（29眼）、20 例（30 眼）。同时随机选取同期健康体检者60 例（120 眼）作为对照组。各组研究对象分别通过mfERG进行技术诊断,观察比较mfERG二阶反应各环与各象限的P1 波反应密度值及潜伏期。组间数据比较采用单因素方差分析和 χ2检验。结果：与对照组相比,早期青光眼组1～5环的P1波反应密度值无明显变化,差异无统计学意义,但颞下、颞上象限P1波反应密度值下降明显,差异有统计学意义（P < 0.05）。中期青光眼组2～5环及4个象限P1波反应密度值较对照组下降明显,差异均有统计学意义（P < 0.05）。晚期青光眼组1～5环及4个象限P1波反应密度值较对照组明显下降,差异均有统计学意义（P < 0.05）。早、中、晚期青光眼组1～5环及4个象限P1波的潜伏期均较对照组延长,差异均有统计学意义（P < 0.05）。各期青光眼组中,晚期青光眼组较早期青光眼组潜伏期延长更明显,差异有统计学意义（P < 0.05）。结论：mfERG 1～5 环P1波潜伏期和密度值的变化可在一定程度上反映青光眼视网膜的损害程度,对诊断早期POAG有一定的临床价值。     

原发性开角型青光眼非对称性视野损害的影响因素

目的：探讨原发性开角型青光眼（POAG）非对称性视野损害的相关因素,并了解非对称性视野损害者双眼间眼部参数的差异。方法：横断面研究。收集2014年1月至2018年12月温州青光眼进展研究 （WGPS）中确诊的POAG患者,分析双眼眼部参数,包括眼压、眼轴长度（AL）、中央角膜厚度（CCT）、 前房深度（ACD）、晶状体厚度（LT）、视野平均偏差（MD）、视网膜神经纤维层厚度（RNFLT）、盘沿 面积、视盘面积、杯盘比、视杯容积。非对称性视野损害定义为双眼视野MD的绝对差值≥5 dB, 根据此标准将受检者分为对称组和非对称组,分析2组眼部参数与非对称性视野损害的关系。非对称组进一步行双眼间眼部参数的比较。采用独立样本t检验、Mann-Whitney U检验、配对t检验、 Wilcoxon检验、Logistic回归分析对数据进行分析。结果：共纳入POAG患者142例（284眼）,对称组 92例（64.8%）,男39例（42.4%）,年龄（65.3±1.0）岁;非对称组50例（35.2%）,男32例（64.0%）,年 龄（67.6±9.1）岁。男性[OR=4.52,95%可信区间（CI）：1.90～10.73,P=0.001]、较差眼的CCT较薄 （OR=0.97,95%CI：0.95～0.99,P=0.003）、双眼平均RNFLT差值增大（OR=1.10,95%CI：1.04～1.15, P<0.001）为非对称性视野损害的危险因素。非对称组中,视野损害较重眼相比对侧眼,其平均 RNFLT较薄（Z=-7.80,P<0.001）,盘沿较窄（t=-4.97,P<0.001）,视盘面积较大（t=2.38,P=0.02）, 平均杯盘比（Z=-4.51,P<0.001）和垂直杯盘比（Z=5.16,P<0.001）均较大,视杯容积较大（Z=-3.31, P<0.001）,但双眼间眼压、等效球镜度（SE）、AL、CCT、LT和ACD的差异均无统计学意义。结论：男性、CCT较薄、双眼平均RNFLT差值增大为POAG非对称性视野损害的独立危险因素,而非对称性视野损害者其双眼中的较大视盘眼,更容易发生视神经损害。     

青光眼静态阈值不对称

通过比较双眼Ｂｊｅｒｒｕｍ区平均光敏感度（ＭＳ），分析３６名至少１眼有早或中期视野缺损的青光眼和４２名正常人自动视野检查资料，应用自定的标准，获得８０．６％（２９／３６）的敏感性和８８．１％（３７／４２）的特异性。在青光眼组，较低ＭＳ眼多为较高眼压眼，在有不对称Ｄ／Ｄ值或相对性传入瞳孔障碍者，较大青光眼杯或传入性瞳孔障碍眼ＭＳ恒低于对侧眼。     

Biomechanical Glaucoma Factor and Corneal Hysteresis in Treated Primary Open-Angle Glaucoma and Their Associations With Visual Field Progression

PurposeTo investigate the relationship between biomechanical glaucoma factor (BGF) measured with Corvis ST and glaucomatous visual field (VF) progression, compared to corneal hysteresis (CH) measured with ocular response analyzer using a longitudinal dataset of primary open-angle glaucoma (POAG). The discriminative powers of BGF and CH were also compared using a cross-sectional dataset.MethodsThe longitudinal dataset included 166 POAG eyes. The rate of VF change during the follow-up period was evaluated using the mean of 52 pointwise total deviations in the Humphrey 24-2 field test. Variables associated with the VF progression rate were identified from BGF, CH, age, baseline VF severity, and intraocular pressure during the VF follow-up period by identifying the optimal model. The cross-sectional dataset included 68 POAG eyes and 68 healthy eyes. Using this dataset, the area under the curve (AUC) values of the receiver-operating curve were compared between CH and BGF.ResultsThe optimal multivariate linear mixed model to describe the VF rate included age and CH, but not BGF. Between POAG and healthy eyes, CH was statistically different (P < 0.001), although this was not the case with BGF. The AUC values were 0.61 and 0.71 for BGF and CH, respectively (P = 0.027).ConclusionsCH, but not BGF, was associated with VF progression in POAG patients under treatment. BGF was not useful to discriminate POAG between treated and normal eyes.     

青睫综合征与原发性开角型青光眼

报告２９例青睫综合征患者，全部作角膜内皮、前房角、视野、杯盘比、视网膜神经纤维层检查，其中２５例亦作ＶＥＰ检查。结果表明：青睫综合征并不是一种预后良好的自愈性疾病，而是一种可造成青光眼性视功能损害的疾病。它是否与原发性开角型青光眼有联系有待研究。     

Prospective Study of Alcohol Consumption and the Risk of Primary Open-Angle Glaucoma

Purpose: Alcohol intake reduces intraocular pressure, a risk factor for primary open-angle glaucoma (POAG). We investigated whether alcohol consumption is associated with a reduced risk of POAG. Methods: We followed female nurses from 1980 and male health professionals from 1986 to 2002. Eligible participants were 40+ years old, did not have POAG, and reported receiving eye examinations during follow-up. Information on alcohol consumption, potential confounders and POAG diagnoses were updated by using biennial questionnaires. We identified 856 self-reported POAG cases that were confirmed with medical record review. Cohort-specific and pooled analyses across cohorts were conducted to calculate multivariable rate ratios (RR) of POAG. Results: Alcohol consumption < 30 g/day did not influence POAG risk: compared with non-drinkers, the pooled RRs were 0.99 (95% Confidence Interval [CI]: 0.83–1.19) for drinking < 10 g/day, 0.96 (95% CI: 0.76–1.22) for 10–19 g/day, and 0.95 (95% CI: 0.68–1.33) for 20–29 g/day. Although there were suggestive inverse associations with drinking > 30 g/day (RR = 0.71), this was not significant (95% CI: 0.49–1.04), and no significant linear associations were detected. Risks of POAG did not differ by type of alcoholic beverage consumed. To evaluate the potential for detection bias, we controlled for additional factors, such as frequency of eye exams, but results were similar. Conclusion: In this large prospective study of men and women, alcohol consumption did not influence the risk of POAG.     

Personality Assessment Based on the Five-factor Model of Personality Structure in Patients with Primary Open-Angle Glaucoma

Purpose Several characteristic personality types have been reported for glaucoma patients in previous studies. However, none of the previous studies used a common structural theory of personality. In this study, we conducted a multicenter cross-sectional case–control study using the recently established five-factor model of personality structure.Methods Personality was evaluated using the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), which is a questionnaire specifically designed to test the five-factor model of personality: neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Eligible questionnaires were obtained from 196 patients with primary open-angle glaucoma (POAG) (99 men, 97 women) and 223 reference subjects with no ocular disease except cataract (87 men, 136 women). The mean score of each NEO-FFI factor for POAG patients was compared to the scores for the reference subjects.Results Compared with the reference subjects, the mean N score was significantly higher (P = 0.013), the mean scores for A and C were significantly lower (P = 0.007 and P = 0.001, respectively), and the mean E score tended to be lower (P = 0.055) in male POAG patients. The mean E score was significantly lower (P = 0.023) in female POAG patients.Conclusions Characteristic personality traits were noted in POAG patients, and a more significant relationship was found between personality and glaucoma in men than in women. Jpn J Ophthalmol 2005;49:31–35 © Japanese Ophthalmological Society 2005     

Longitudinal Changes in Macular Optical Coherence Tomography Angiography Metrics in Primary Open-Angle Glaucoma With High Myopia: A Prospective Study

PurposeTo characterize longitudinal changes in macular microvasculature as quantified from optical coherence tomography angiography (OCTA) metrics in primary open-angle glaucoma (POAG) eyes with and without high myopia.MethodsIn total, 63 and 61 POAG eyes with and without high myopia, respectively, underwent swept-source OCTA imaging in at least four follow-up visits at an ophthalmic center, with a scanning protocol of 3- × 3-mm centered at the fovea. The foveal avascular zone (FAZ) area, FAZ circularity, and vessel density (VD) in both the superficial (SCP) and deep capillary plexuses (DCP) were measured. The rate of change in macular OCTA metrics over time was estimated using linear mixed-effects models in both groups of POAG eyes.ResultsThe mean follow-up time and number of visits were 27.72 ± 8.57 months and 8.5 (8 to 13) times, and 30.95 ± 10.19 months and 10 (8‒13) times in POAG eyes with and without high myopia, respectively. VD in the DCP reduced significantly more quickly in POAG eyes with high myopia than in those without high myopia (−5.14%/year vs. −3.71%/year, P = 0.008). Moreover, lower baseline VD in the DCP was significantly associated with faster VD reduction in POAG with high myopia eyes (P < 0.001). Conversely, the VD reduction rate in the SCP, FAZ area, and FAZ circularity in both the SCP and DCP were similar in both groups (all Ps > 0.05).ConclusionsVD in DCP reduced significantly more quickly in POAG eyes with high myopia over time. Density in the DCP reduced more quickly when baseline VD was low.     

A Comparison of Central Corneal Thicknesses Measured with Two Different Methods in Cases of Primary Open-Angle Glaucoma

Accurate and repeatable measurement of the central cornea thickness (CCT) is important in terms of follow-up of glaucoma patients. The aim of this study was to compare CCT measurements made with an ultrasonic pachymeter (USP) and with the Spectralis Anterior Segment Module optical coherence tomography (OCT) device. The study included 52 eyes of 26 primary open-angle glaucoma patients. CCT measurements were taken with the USP device and then with the OCT by imaging cornea slices. The mean CCT was measured as 555.71 ± 47.76 μm with USP and 569.46 ± 49.5 μm with OCT. Despite the differences between the measurements of the two methods, a very strong degree of consistency was seen between the CCT measurement with USP and OCT (ICC = 0.93, p < 0.001).     

Characteristics of Undiagnosed Primary Open-Angle Glaucoma: The Tajimi Study

Purpose: To evaluate the characteristics of patients with previously undiagnosed primary open-angle glaucoma (POAG) in the Tajimi Study.

Methods: Background and ophthalmic examination data from 111 patients previously undiagnosed with POAG from the Tajimi Study, a population-based survey of glaucoma, were analyzed and compared with those of eight patients with previously diagnosed glaucoma.

Results: The mean deviation (MD) and vertical cup-to-disc ratio (vC/D) of the worse eye of each patient averaged ?5.5 decibels (dB) and 0.72 and ?10.4?dB and 0.83, respectively, in undiagnosed and diagnosed POAG. In undiagnosed POAG, arcuate and partial arcuate patterns accounted for 50% of the pattern of the visual field (VF) damage, and 95% of patients presented with intraocular pressure of 21?mmHg or less (normal tension glaucoma). The undiagnosed group had better MD and smaller vC/D values in the worse eye and less involvement of bilateral VFs than the diagnosed group (p?=?0.004–0.050 with Bonferroni correction), while other factors, including mean sensitivity of the binocular VF, showed no intergroup difference.

Conclusion: The characteristics of Japanese patients with previously undiagnosed POAG indicated that bilateral evaluation of the optic disc and VF are important for identifying individuals with glaucoma.     

Association Between Open-Angle Glaucoma and Gene Polymorphism for Heat-Shock Protein 70-1

Purpose

Heat-shock proteins (HSPs) or antibodies against them may contribute to glaucomatous optic neuropathy. We investigated the associations of HSP70-1 polymorphisms with open-angle glaucoma (OAG) in a Japanese population.

Methods

In 241 normal Japanese controls and 501 Japanese OAG patients, including 211 with primary open-angle glaucoma (POAG) and 290 with normal-tension glaucoma (NTG), two single-nucleotide polymorphisms, A?110C and G+190C, of HSP70-1 were identified by using an Invader assay and polymerase chain reaction-restriction fragment length polymorphism, respectively. Genotype distributions were compared between controls and OAG patients. Age at diagnosis, untreated maximum intraocular pressure, and visual field defects at diagnosis were examined for associations with the polymorphisms.

Results

Distribution of the A?110C genotype (AA versus AC+CC) differed significantly between controls and OAG patients (P = 0.007), POAG patients (P = 0.007), or NTG patients (P = 0.032). The genotype distribution of the G+190C polymorphism did not differ significantly between the controls and any patient group. No significant differences in the clinical characteristics of the patients were detected between genotype-defined groups by logistic regression analysis.

Conclusion

The A?110C polymorphism of HSP70-1 may be associated with OAG pathogenesis in Japanese patients.?Jpn J Ophthalmol 2007;51:417–423 © Japanese Ophthalmological Society 2007

     

Phacotrabeculectomy in Treatment of Primary Angle-closure Glaucoma and Primary Open-angle Glaucoma

Purpose To evaluate the surgical outcome of combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy (phacotrabeculectomy) in patients with primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG).Methods The records of 57 consecutive patients (65 eyes) with PACG or POAG that were treated with phacotrabeculectomy were reviewed retrospectively. There were 31 eyes with PACG and 34 with POAG. The mean follow-up period was 21.0 ± 8.3 months. The visual acuity, intraocular pressure (IOP), number of medications, and complications were evaluated.Results The mean IOP and the number of glaucoma medications decreased significantly after phacotrabeculectomy in both groups. The mean IOP reduction was significantly greater in eyes with PACG (P < 0.05). The absolute success rates were 87.1% and 70.6% in PACG and POAG, respectively. The difference in the success rates was not significant (P = 0.297). The early postoperative complication rates were similar in both groups.Conclusions Phacotrabeculectomy results in greater IOP reduction in eyes with PACG than in those with POAG, but the overall success rates were not significantly different. Jpn J Ophthalmol 2004;48:408–411 © Japanese Ophthalmological Society 2004     

24小时血压参数与原发性开角型青光眼视神经损害的相关性

目的：研究24 h血压参数与原发性开角型青光眼（POAG）视神经损害之间的相关性。方法：病例对照研究。选择2013年6月至2016年12月期间成都市第一人民医院确诊的60例POAG患者作为POAG组,55 例正常人群作为对照组。2 组均进行24 h眼压和血压的同步监测,比较2 组受检者24 h血压参数、眼灌注压及眼压的差异,并分析POAG组患者24 h血压参数、眼灌注压及眼压与相关视功能之间的关系。采用独立样本t检验和多重线性回归等进行统计学分析。结果：①POAG组的24 h平均眼压、眼压差、眼灌注压差及脉压差显著高于对照组,2 组差异均有统计学意义（t =3.22、6.57、2.29、2.39,P ＜0.05）。②POAG组平均收缩压显著高于对照组（t =3.02,P =0.003）,其收缩压最高值、收缩压波动值、夜间平均收缩压、夜间最高收缩压及其波动值均显著高于对照组（t =4.38、5.27、4.13、4.13、 4.14,P ＜0.001）。③POAG组24 h平均舒张压、舒张压最高值、夜间平均舒张压、夜间舒张压最高值也显著高于对照组（t =2.22、2.50、2.29、2.10,P ＜0.05）。④POAG组患者的24 h血压相关参数与视神经损害相关性：平均眼压是POAG视野的平均缺损值（MD）的影响因素,二者呈负相关（b =-0.44,P =0.004）;盘周平均视网膜神经纤维层（RNFL）厚度与平均眼压（b =-0.956,P =0.001）、眼压差（b =-1.125,P =0.003）呈负相关;夜间平均舒张压（b =0.395,P ＜0.001）和夜间平均动脉压（b =0.046,P =0.001）分别与AP100和AP50值呈正相关。结论：①24 h血压相关参数与POAG的视神经损害之间存在相关性;②夜间眼灌注压、夜间舒张压和夜间动脉压可能是POAG视神经损害的影响因素;③在POAG的治疗中,稳定的血压和靶眼压有利于保持有效的稳定的眼灌注压,提示在关注降眼压治疗POAG的同时应该关注血压的变化。     

臂间收缩压差对原发性青光眼视野进展的影响

目的：探讨臂间收缩压差（IASBPD）对眼压已控制的原发性青光眼患者视野损害进展的影响。方法： 前瞻性临床研究。选择2013年8月至2018年11月就诊于长沙爱尔眼科医院的原发性青光眼患者69例 （69眼）,均行5次以上视野检查。根据Humphrey视野计的青光眼进展引导分析（GPA）结果分为视野 进展组和视野无进展组,对所有受检者进行多次双臂序贯血压测量。采用两独立样本t检验、Fisher's 精确概率法及Logistic回归进行数据分析。结果：最终纳入患者34例（34眼）,其中视野进展组15例 （15眼）,无进展组19例（19眼）,2组的IASBPD分别为（10.6±9.0）mmHg（1 mmHg=0.133 kPa）、 （5.3±2.8）mmHg,视野进展组较无进展组高5.26 mmHg（95%可信区间为0.14～10.37 mmHg）,差 异有统计学意义（t=-2.177,P=0.045）。2组间脉压差、平均动脉压、舒张期眼灌注压差异均无统 计学意义（t=0.946、-1.118、-1.967,P>0.05）。Logistic回归分析结果显示IASBPD≥10 mmHg 是视野进展的一个危险因素（OR=20.310,P=0.022）。将患者分为IASBPD<10 mmHg组（26眼）和 IASBPD≥10 mmHg组（8眼）,2组的视野进展率分别为30.8%和87.5%,2组的视网膜神经纤维层厚 度进展率分别为42.3%和87.5%,差异均具有统计学意义（P=0.011、0.030）。结论：IASBPD增大可能 是眼压已控制的原发性青光眼患者视野进展的危险因素之一。     

Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia

PurposeThe purpose of this study was to investigate the ocular and hemodynamic factors contributing to the central visual function in glaucoma patients with myopia.MethodsThis study was a prospective observational study, which included 236 eyes of 140 patients with normal-tension glaucoma (NTG), which includes 114 eyes with mild myopia (axial length ≥24 and <26 mm) and 122 eyes with moderate-to-severe myopia (axial length ≥26 mm). Ocular characteristics were axial length and posterior pole profiles, including peripapillary atrophy (PPA) to disc area ratio, disc tilt ratio, disc torsion, and disc-foveal angle. Hemodynamic factors included standard deviation of the mean of qualified normal-to-normal intervals (SDNN) of a heart rate variability (HRV) test and vessel density (VD) parameters from optical coherence tomography angiography (OCTA). The root mean square error was estimated as a measure of the VD fluctuation. Association between ocular characteristics and VD parameters of the OCTA with the central sensitivity of the 10-degree visual field or the presence of central scotoma were analyzed.ResultsDeep layer VD of the peripapillary and macular areas showed significant differences between mild and moderate-to-severe myopia (P = 0.034 and P = 0.045, respectively). Structural parameters, especially PPA to disc area ratio, had significant correlation with peripapillary VD parameters in myopic eyes. Lower SDNN value (ß = 0.924, P = 0.011), lower deep VD of the macular area (ß = 0.845, P = 0.001), and greater fluctuation of deep VD in the peripapillary area (ß = 1.517, P = 0.005) were associated with the presence of central scotoma in patients with glaucoma with myopia in multivariate logistic regression analysis.ConclusionsThe structural changes by myopia, especially in the peripapillary region, affected VD parameters in myopic eyes. Lower deep VD and greater VD fluctuation in the peripapillary region showed association with central scotoma in patients with glaucoma with myopia, suggesting both structural and vascular changes by myopia may be related to central visual function in glaucoma patients with myopia.