The Longitudinal Danish High Myopia Study, Cohort 1948: at age 66 years visual ability is only occasionally affected by visual field defects

Acta Ophthalmol. 2019 Feb;97(1):36-43. doi: 10.1111/aos.13820. Epub 2018 Oct 3.

Abstract

Purpose: A descriptive study on visual fields, as part of a 50-year follow-up of high myopia in an unselected cohort-based Danish sample, now aged 66 years.

Methods: In a Copenhagen 1948 birth cohort (n = 9243), 39 individuals aged 14 years were identified with myopia of at least -6 D, and with regular clinical follow-ups since then. In 2002 (n = 34, age 54 years) and 2008 (n = 32, age 60), the individual ambulatory visual field was outlined by kinetic Goldmann large object perimetry (IV or V,4e). At age 66 years, 28 attended for the 2014-2015 follow-up, at which smaller Goldmann objects (II and I,4e) were added, further to identify relative defects.

Results: Repeated large object perimetry disclosed statistically significant general peripheral narrowing over the 12-13-year test period, though slight and without practical implications. Two new cases showing absolute defects were however added to the three already known. The addition of small Goldmann objects disclosed relative defects in another eight participants, in some to suggest a refraction-related pattern (fundus ectasia; uncorrected high myopia). However, comparing eyes with and without defects, statistical importance could not be attached to the degree of myopia, fundus ectasia or optic disc morphology (χ2 , n.s.).

Conclusion: (i) Serial large object Goldmann isopters over the 'senior' decade up to age 66 demonstrated a slight general peripheral narrowing by age of visual fields in high myopia. (ii) Overall 42% of the participants had absolute or relative defects (in 5 and 8, respectively), however, without socio-visual consequences when binocular. (iii) Visual field loss by age still appears a minor issue in clinically unselected high myopia.

Keywords: age; high myopia; kinetic goldmann perimetry; optos fundus evaluation; population derived data; visual field.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Denmark / epidemiology
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications
  • Myopia, Degenerative / epidemiology*
  • Myopia, Degenerative / physiopathology
  • Optic Disk / diagnostic imaging
  • Retrospective Studies
  • Scotoma / epidemiology*
  • Scotoma / etiology
  • Scotoma / physiopathology
  • Visual Acuity*
  • Visual Field Tests
  • Visual Fields / physiology*
  • Young Adult