Long-Term Prediction and Risk Factors for Incident Visual Field Defect in Nonpathologic High Myopia

Purpose: To investigate the long-term patterns and risk factors of visual field defect (VFD) development in nonpathologic high myopia (HM) over an 8-year follow-up. Methods: This was an observational cohort study. The VFD classification adhered to the Glaucoma Suspects with High Myopia Study Group. Logistic regression models with generalized estimating equations were used to identify risk factors for VFD development. Results: A total of 330 eyes from 194 patients were included. Among them, 49.4% of eyes developed VFD, with enlarged blind spot and nonspecific defect ranked as the most common VFDs, followed by partial arcuate defect, vertical step, nasal step, paracentral defect, and combined defects. Longer axial length (odds ratio [OR] = 1.43 per 1-mm increase; 95% CI, 1.04-1.95; P = 0.026), thinner central corneal thickness (OR = 1.01 per 1-µm decrease; 95% CI, 1.003-1.02; P = 0.013), worse mean deviation of visual field (OR = 1.51 per 1-dB decrease; 95% CI, 1.14-2.00; P = 0.004), and the presence of peripapillary γ-zone (OR = 5.57; 95% CI, 3.06-10.15; P < 0.001) at baseline correlated with the development of any VFD. By incorporating these factors, the prediction models achieved area under the curves of 0.789 (95% CI, 0.726-0.853) and 0.828 (95% CI, 0.714-0.943) for discriminating the development of any VFD and moderate/severe VFD, respectively, with good calibration power. Conclusions: The development of VFD occurred frequently in individuals with nonpathologic HM and can be effectively predicted using relevant metrics. The findings will aid in expanding our knowledge of optic neuropathy in HM.