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Introduction <p>The aim of our work is to evaluate stereoscopic photographic changes in the optic nerve head among patients with glaucoma-compatible optic neuropathy in myopia (GCON-M) after intraocular pressure (IOP) reduction and to determine whether these changes represent true progressive glaucomatous damage.</p> Methods <p>This self-controlled, observational cohort study included 41 patients with bilateral normal-tension GCON-M. The eye with the worse baseline visual field (VF) mean deviation received intraocular pressure (IOP)-lowering treatment targeting a 30% reduction, while the fellow eye served as an untreated control. Participants underwent serial VF testing and stereophotographic imaging over a median follow-up of 48&#xa0;months. Structural and functional progression was compared between the treated and control eyes.</p> Results <p>Among the 41 patients (82 eyes), the treatment group achieved a mean IOP reduction of 31.1%, significantly greater than that in the control group (<i>P</i> &lt; 0.001). There was no significant difference between the groups in the change in VF mean deviation (<i>P</i> = 0.25) or structural progression scores (<i>P</i> = 0.37). Disease progression occurred in 9.7% of treated and 12.2% of control eyes. Kaplan–Meier analysis showed no significant difference in progression-free survival between the groups (<i>P</i> = 0.76), which was further confirmed by multivariate Cox regression analysis (<i>P</i> = 0.67).</p> Conclusions <p>The long-term stability of GCON-M in many untreated eyes suggests that these changes may represent non-progressive remodeling rather than true glaucomatous damage. These findings argue against routine glaucoma therapy and support an individualized monitoring strategy to avoid overtreatment.</p>

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Stereophotographic Assessment of Intraocular Pressure Reduction in Myopic Eyes with Glaucoma-Compatible Optic Neuropathy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月11日

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  • Yang Zhang,
  • Ailing Bian,
  • Qi Zhou,
  • Lüe Li,
  • Yu Jin,
  • Zixi Sun,
  • Youxin Chen,
  • Gangwei Cheng

摘要

Introduction

The aim of our work is to evaluate stereoscopic photographic changes in the optic nerve head among patients with glaucoma-compatible optic neuropathy in myopia (GCON-M) after intraocular pressure (IOP) reduction and to determine whether these changes represent true progressive glaucomatous damage.

Methods

This self-controlled, observational cohort study included 41 patients with bilateral normal-tension GCON-M. The eye with the worse baseline visual field (VF) mean deviation received intraocular pressure (IOP)-lowering treatment targeting a 30% reduction, while the fellow eye served as an untreated control. Participants underwent serial VF testing and stereophotographic imaging over a median follow-up of 48 months. Structural and functional progression was compared between the treated and control eyes.

Results

Among the 41 patients (82 eyes), the treatment group achieved a mean IOP reduction of 31.1%, significantly greater than that in the control group (P < 0.001). There was no significant difference between the groups in the change in VF mean deviation (P = 0.25) or structural progression scores (P = 0.37). Disease progression occurred in 9.7% of treated and 12.2% of control eyes. Kaplan–Meier analysis showed no significant difference in progression-free survival between the groups (P = 0.76), which was further confirmed by multivariate Cox regression analysis (P = 0.67).

Conclusions

The long-term stability of GCON-M in many untreated eyes suggests that these changes may represent non-progressive remodeling rather than true glaucomatous damage. These findings argue against routine glaucoma therapy and support an individualized monitoring strategy to avoid overtreatment.