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Clinical science
Corneal hysteresis as a biomarker in glaucoma development among patients with myopia: a prospective study based on the UK Biobank
  1. Jae-Seung Yun1,
  2. Sang-Hyuk Jung2,
  3. Seung Min Jung3,
  4. Hong-Hee Won4,
  5. Dokyoon Kim5,
  6. Jin A Choi6
  1. 1 Department of Internal Medicine, The Catholic University of Korea St Vincent’s Hospital, Suwon, Korea (the Republic of)
  2. 2 Department of Medical Informatics, Kangwon National University College of Medicine, Chuncheon, Korea (the Republic of)
  3. 3 The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)
  4. 4 Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea (the Republic of)
  5. 5 University of Pennsylvania, Philadelphia, Pennsylvania, USA
  6. 6 Ophthalmology, The Catholic University of Korea St Vincent’s Hospital, Suwon, Korea (the Republic of)
  1. Correspondence to Dr Jin A Choi; jinah616{at}catholic.ac.kr

Abstract

Background/aims We investigated the impact of potential risk factors on the development of incident glaucoma in individuals with myopia.

Methods This prospective cohort study investigated participants aged 40–69 years from the UK Biobank. Participants were classified based on the degree of myopia: non-myopic (spherical equivalent (SE)≤−0.5D), mild myopia (−3.0D<SE≤−0.5 D), moderate myopia (−6.0 D<SE≤−3.0 D) and high myopia (SE≤−6.0D). Cox proportional-hazard models assessed the relationship of ocular and systemic risk factors with new glaucoma events across the myopia subgroups.

Results Of 105 548 participants who did not have prior glaucoma, 35 870 were classified as myopic and 69 678 as non-myopic. A total of 1877 incident glaucoma cases (1.78%) were documented during a median 11.1 years of follow-up. Those who developed glaucoma had lower SE, lower corneal hysteresis (CH) and higher intraocular pressure. Systemic factors such as type 2 diabetes, dyslipidaemia, baseline fasting blood sugar and haemoglobin A1c were significantly higher in those who developed glaucoma, but only in the non-myopia and mild myopia subgroups. Degree of myopia and low CH (≤10.1 mm Hg) were significantly associated with increased glaucoma incidence. When we explored the impact of CH on the risk of incident glaucoma according to myopia grade, consistent elevation of risk with low CH was observed, with the highest risk being exhibited in the high myopia population (HR 1.67 (95% CI 1.10 to 2.57)).

Conclusions Our results demonstrated a significant joint association between CH and myopia regarding glaucoma development, suggesting that altered ocular biomechanical properties could play a pronounced role in glaucoma development, particularly within the highly myopic population.

  • Glaucoma
  • Cornea
  • Epidemiology

Data availability statement

Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data may be obtained from a third party and are not publicly available.

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Footnotes

  • Contributors JAC contributed to the design, analysis, interpretation and drafting of the work. J-SY contributed to the design, analysis and critical revision of the work. S-HJ and SMJ contributed to the design and critical revision of the work. H-HW and DK contributed to the acquisition, interpretation and critical revision of the work. All authors gave final approval of the work, are accountable for the parts of the work they contributed to and have confidence in the integrity of the contributions of their coauthors. JAC is responsible for the overall content as the guarantor.

  • Funding The National Research Foundation of Korea Grant funded by the Korean government (MSIP) (No. NRF- 2022R1A2C1012677).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.