Forty-nine myopic patients (70 eyes) aged 2 to 12 years (mean 7 +/- 4.2 years) with primary open-angle glaucoma (POAG) were examined. In patients with glaucoma concurrent with myopia, enlarged peripapillary retinal atrophy is one of the first signs of a progressive process, long optical axis in particular. Reduced visual functions were detectable in fewer cases than were changes in the optic disk and peripapillary retina. The most sensitive methods are in the following order: distant contrast discrimination (DCD), critical flicker fusion frequency (CFFF), Bjerrum's zones, statitic perimetry with a blue object on the Friedman analyzer, automatic static permentry on the Peritest, isoptoperimetry. In patients with POAG and in the majority of POAG concurrent with myopia with an anteroposterior axis (APA) of < 25 mm, excavation was shown to progress depthward and/or widthway with simultaneous narrowing of the neuroretinal rim. In patients with POAG concurrent with myopia at an APA of > 25 mm, peripapillary atrophy initially increased (usually in the temporal quadrant), excavation also widthway in the temporal direction. It is evident from the foregoing that increased peripapillary atrophy may be considered to be a marker of progression of the glaucomatous process in patients with myopia.

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