To verify the dose-response relation between degree of myopia and open-angle glaucoma (OAG) risk DESIGN: Dose-response meta-analysis METHODS: We searched the PubMed, EMBASE, and Cochrane databases for population-based studies published until 30 November 2020 and reporting on both myopia and OAG. Random-effect models generated pooled odds ratios (OR) and 95% confidence intervals (CIs). Results robustness was confirmed by influence and subgroup analyses. A two-stage dose-response meta-analysis (DRMA) calculated the OAG risk per unit dose of myopia (spherical equivalent [SE] decrease of 1 diopter [D]) and examined the relationship pattern.
Twenty-four (24) studies in 11 countries (514,265 individuals) made up the meta-analyses. The pooled OR of any myopia degree’s association with OAG was 1.88 (95% CI, 1.66-2.13; I=53%). The OR differences based on ethnicity (Asians vs. Westerners) or 5 geographic areas were not statistically significant (P=0.80 and 0.06, respectively). The pooled ORs of the associations between low, moderate, moderate-to-high, high myopia, and OAG were 1.50 (95% CI, 1.29-1.76), 1.69 (1.33-2.15), 2.27 (1.74-2.96), and 4.14 (2.57-6.69), respectively. According to the DRMA, the pooled OR (per SE 1 D change) was 1.21 (95% CI, 1.15-1.28); the OAG risk accelerated at around -6 D, and further accelerated from -8 D, showing a non-linear concave upward slope (P=0.03).
We found that for each unit (1 D) increase in myopia, the risk of glaucoma increases by approximately 20%. The risk more steeply increases in high-degree myopia, representing a significant non-linear relationship.

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