Effects of Physiologic Myopia and Aging on Visual Fields in Normal Eyes

PURPOSE: The purpose of this study was to investigate how mild-to-moderate myopia and aging affect visual field sensitivity (VF-S) in normal eyes, correcting for effects of each. DESIGN: Combined cross-sectional and cohort study. METHODS: Two normal groups, a cross-sectional group (n = 703; 1,051 eyes; mean age, 52.6 years) and a lon-gitudinal group (n = 44; 83 eyes; mean age, 52.3 years; follow-up, 4.2 years; VF tests, 12) were included. In the cross-sectional group, the mean VF-S of the entire field and 3 disc portion-oriented subfields of the Humphrey Field Analyzer 24-2 program were correlated with sub-jects' age, axial length (AL), disc, rim and beta-peripapillary area, and disc ovality and torsion, using linear mixed-regression models. Their time changes in the longitudinal group were correlated with time, subjects' ages, and AL using linear mixed-regression models. RESULTS: In the cross-sectional group, the VF-S correlated negatively with age (-0.081 decibel [dB]/year; P <.001), which was more negative (P =.020) in the midperipheral than the central subfield, and with AL (P =.049) without intersubfield differences. In the lon-gitudinal group, no changes in the ocular media were significant, and the VF-S declined by 0.074 dB/year (P =.007), which accelerated with higher age (P <.002) and baseline VF-S (P <.001) without intersubfield dif-ferences. The AL showed little effects on the VF-S lon-gitudinal changes. CONCLUSIONS: In normal eyes with mild-to-moderate myopia, the VF-S was lower subfield-independently with longer AL, whereas the AL had little effect on the aging-associated VF-S reduction. The VF-S de-creased with aging with intersubfield differences. The aging-associated VF-S reduction accelerated with higher age, to which the ocular media changes were un-related. (Am J Ophthalmol 2021;230: 224-233. (c) 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NCND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/))

Automated summary

This study found that mild-to-moderate myopia and aging can reduce visual field sensitivity in normal eyes, with little effect from axial length. The reduction in visual field sensitivity accelerates with age and shows intersubfield differences.