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Glaucoma in myopia: diagnostic dilemmas.

Publication ,  Journal Article
Tan, NYQ; Sng, CCA; Jonas, JB; Wong, TY; Jansonius, NM; Ang, M
Published in: Br J Ophthalmol
October 2019

Myopic eyes have an increased risk of glaucoma. However, glaucomatous changes in a myopic eye are often difficult to detect. Classic structural and functional investigations to diagnose glaucoma may be confounded by myopia. Here, we identify some of the common pitfalls in interpreting these structural parameters, and the possible solutions that could be taken to overcome them. For instance, in myopic eyes, we discuss the limitations and potential sources of error when using neuroretinal rim parameters, and retinal nerve fibre layer and ganglion cell-inner plexiform layer thickness measurements. In addition, we also review new developments and potential adjuncts in structural imaging such as the assessment of the retinal nerve fibre layer texture, and the examination of the microcirculation of the optic nerve head using optical coherence tomography angiography. For the functional assessment of glaucoma, we discuss perimetric strategies that may aid in detecting characteristic visual field defects in myopic glaucoma. Ultimately, the evaluation of glaucoma in myopia requires a multimodal approach, to allow correlation between structural and functional assessments. This review provides overview on how to navigate this diagnostic dilemma.

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Published In

Br J Ophthalmol

DOI

EISSN

1468-2079

Publication Date

October 2019

Volume

103

Issue

10

Start / End Page

1347 / 1355

Location

England

Related Subject Headings

  • Visual Fields
  • Vision Disorders
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • Optic Disk
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Myopia
  • Microcirculation
  • Humans
 

Citation

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Tan, N. Y. Q., Sng, C. C. A., Jonas, J. B., Wong, T. Y., Jansonius, N. M., & Ang, M. (2019). Glaucoma in myopia: diagnostic dilemmas. Br J Ophthalmol, 103(10), 1347–1355. https://doi.org/10.1136/bjophthalmol-2018-313530
Tan, Nicholas Y. Q., Chelvin C. A. Sng, Jost B. Jonas, Tien Yin Wong, Nomdo M. Jansonius, and Marcus Ang. “Glaucoma in myopia: diagnostic dilemmas.Br J Ophthalmol 103, no. 10 (October 2019): 1347–55. https://doi.org/10.1136/bjophthalmol-2018-313530.
Tan NYQ, Sng CCA, Jonas JB, Wong TY, Jansonius NM, Ang M. Glaucoma in myopia: diagnostic dilemmas. Br J Ophthalmol. 2019 Oct;103(10):1347–55.
Tan, Nicholas Y. Q., et al. “Glaucoma in myopia: diagnostic dilemmas.Br J Ophthalmol, vol. 103, no. 10, Oct. 2019, pp. 1347–55. Pubmed, doi:10.1136/bjophthalmol-2018-313530.
Tan NYQ, Sng CCA, Jonas JB, Wong TY, Jansonius NM, Ang M. Glaucoma in myopia: diagnostic dilemmas. Br J Ophthalmol. 2019 Oct;103(10):1347–1355.

Published In

Br J Ophthalmol

DOI

EISSN

1468-2079

Publication Date

October 2019

Volume

103

Issue

10

Start / End Page

1347 / 1355

Location

England

Related Subject Headings

  • Visual Fields
  • Vision Disorders
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • Optic Disk
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Myopia
  • Microcirculation
  • Humans