Refractive Error, Axial Dimensions, and Primary Open-Angle Glaucoma The Singapore Malay Eye Study

Objective: To explore the relationship of refractive error and ocular biometry with primary open-angle glaucoma (POAG) in the Malay population. Methods: The Singapore Malay Eye Study is a population-based cross-sectional survey that examined 3280 persons (78.7% response) aged 40 to 80 years. Participants underwent a standardized clinical examination including slitlamp biomicroscopy, Goldmann applanation tonometry, refraction, dilated optic disc assessment, and measurement of axial length (AL) and central corneal thickness (CCT). Glaucoma was defined according to International Society for Geographical and Epidemiological Ophthalmology criteria. Results: After adjusting for possible confounders, persons with moderate or high myopia (less than -4.0 diop-ters, right eyes) were more likely to have POAG (odds ratio [OR], 2.87; 95% confidence interval, 1.09-7.53); this association remained significant after controlling for CCT (2.80; 1.07-7.37). Longer AL was associated with POAG (ORs, 2.49, 3.61, and 2.88, comparing quartiles 2, 3, and 4, respectively, with quartile 1 of AL; P=.03 for trend). If CCT was controlled for, persons with AL in quartile 4 were 3 times more likely to have POAG (OR, 3.00; 95% confidence interval, 1.09-8.24) than those in quartile 1. Conclusion: This population-based study in Singapore shows an association of moderate myopia and increasing AL with POAG independent of other factors, including CCT.