Research priorities for diagnostics, progression monitoring, and treatment of glaucoma in myopic eyes

Abstract

Objective: The aim of this study was to report results of a survey on the diagnostics, progression monitoring, and treatment of glaucoma in myopic eyes and identify future research priorities. Methods: We conducted a survey among the members of the European Glaucoma Society to explore their perspectives on the most critical questions regarding glaucoma in myopic eyes. We asked participants to compose critical questions about glaucoma diagnostics, progression monitoring, nonsurgical, and surgical management in myopic eyes. We used large language models to identify the most frequently recurring themes in the questions and human evaluation to validate and calculate responses for each theme. Results: A total of 251 participants out of 1045 responded, of whom 98% were glaucoma specialists, and 86% glaucoma surgeons. We received 581 questions on diagnostics, 470 on progression monitoring, 453 on nonsurgical treatment, and 483 on surgical treatment of glaucoma in myopic eyes. The top themes for diagnostics and progression monitoring were differentiating glaucomatous changes and progression from myopic changes and progression, role and reliability of ocular coherence tomography, and visual field testing and interpretation in myopic eyes. For treatment, the leading themes were choice of surgical procedure, effectiveness of different medications, and effectiveness of selective laser trabeculoplasty in the treatment of glaucoma in myopic eyes. Conclusions: The survey showed that there are knowledge gaps regarding diagnostics, monitoring, and treatment of glaucoma in myopic eyes among glaucoma experts. We recommend that the most frequently recurring themes of this survey are prioritised in future research in this area.