Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis

Objective: To determine the association between myopia and open-angle glaucoma. Design: Systematic review and meta-analysis of observational studies. Participants: Thirteen studies involving 48 161 individuals. Methods: Articles published between 1994 and 2010 were identified in PubMed, Embase, and reference lists. Study-specific odds ratios (ORs) were pooled using a random effects model. Main Outcome Measures: Odds ratios with 95% confidence intervals (CIs) of myopia as a risk factor for open-angle glaucoma. Results: Data from 11 population-based cross-sectional studies were included in the main analyses. The pooled OR of the association between myopia and glaucoma based on 11 risk estimates was 1.92 (95% CI, 1.54-2.38). On the basis of 7 risk estimates, the pooled ORs of the associations between low myopia (myopia up to -3 D) and glaucoma and between high myopia (<= -3 D myopic) and glaucoma were 1.65 (1.26-2.17) and 2.46 (1.93-3.15), respectively. There was considerable heterogeneity among studies that reported an association between any myopia and glaucoma (I-2=53%) and low myopia and glaucoma (I-2=29%), but not for high myopia and glaucoma (I-2=0%). After omitting studies that contributed significantly to the heterogeneity, the pooled ORs were 1.88 (1.60-2.20) for any myopia and glaucoma and 1.77 (1.41-2.23) for low myopia and glaucoma. Conclusions: Individuals with myopia have an increased risk of developing open-angle glaucoma. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2011;118:1989-1994 (C) 2011 by the American Academy of Ophthalmology.