{"id":136,"date":"2018-10-31T13:38:15","date_gmt":"2018-10-31T13:38:15","guid":{"rendered":"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/?p=136"},"modified":"2019-02-22T10:29:55","modified_gmt":"2019-02-22T10:29:55","slug":"miopia-i-glaucoma","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/miopia-i-glaucoma\/","title":{"rendered":"Miopia i glaucoma, estan relacionats?"},"content":{"rendered":"<p class=\"boto2\" align=\"left\"><a class=\"button\" href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/category\/elena-milla\/\" target=\"_blank&amp;\">POST DEL DRA. ELENA MILLA<\/a><\/p>\n<p>La\u00a0<strong>miopia<\/strong>\u00a0\u00e9s la forma m\u00e9s comuna d&#8217;error de refracci\u00f3 ocular, afectant aproximadament 1.600 milions de persones a tot el m\u00f3n (que representen aproximadament el 22% de la poblaci\u00f3) i es preveu que augmenti la seva prevalen\u00e7a a 2.500 milions el 2020. L&#8217;associaci\u00f3 entre\u00a0<strong>miopia i\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/glaucoma\/\" target=\"_blank\" rel=\"noopener noreferrer\">glaucoma<\/a><\/strong>\u00a0est\u00e0 ben establerta,\u00a0entre el\u00a06% i el 29% dels pacients amb\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/tipus-glaucoma-caracteristiques-simptomes-i-causes\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>glaucoma primari d&#8217;angle obert<\/strong><\/a>\u00a0presenten\u00a0<strong>miopia<\/strong>\u00a0simult\u00e0niament.<\/p>\n<p><!--more--><\/p>\n<h2><span class=\"notranslate\"><strong>GRAUS DE MIOPIA<\/strong><\/span><\/h2>\n<p><span class=\"notranslate\">Segons el\u00a0<strong>grau de miopia<\/strong>\u00a0podem distingir entre una forma benigna, amb errors de refracci\u00f3 m\u00e9s lleus de fins a -5 di\u00f2ptries i abs\u00e8ncia d&#8217;alteracions en les diferents estructures oculars.<\/span>\u00a0<span class=\"notranslate\">I una forma de\u00a0<strong>miopia alta<\/strong>\u00a0(o patol\u00f2gica), que representa el 27-33% de tots els pacients miops, en la qual els errors refractius extrems de \u2265 -6.00D i una longitud de l&#8217;ull de&gt; 26 mm s&#8217;associen amb progressius canvis degeneratius del fons d&#8217;ull, deformaci\u00f3 del disc \u00f2ptic, aprimament de la retina i atr\u00f2fia coro\u00efdal.<\/span>\u00a0<span class=\"notranslate\">Aquestes manifestacions cl\u00edniques predisposen un major risc per a l&#8217;individu de desenvolupar altres alteracions oculars.<\/span>\u00a0<span class=\"notranslate\">Aix\u00ed doncs, podem relacionar\u00a0<strong>miopia i\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/glaucoma\/\" target=\"_blank\" rel=\"noopener noreferrer\">glaucoma<\/a><\/strong>, per\u00f2 tamb\u00e9 miopia i\u00a0<a href=\"https:\/\/www.barnaclinic.com\/es\/oftalmologia\/enfermedades-de-la-retina\/#patologia-medica-de-la-retina\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>degeneraci\u00f3 macular<\/strong><\/a>,\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/despreniment-de-retina-faq\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>despreniment de retina<\/strong><\/a>\u00a0o\u00a0<strong><a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/cirugia-de-cataratas-faq\/\" target=\"_blank\" rel=\"noopener noreferrer\">cataracta<\/a><\/strong>\u00a0.<\/span><\/p>\n<h2><\/h2>\n<div id=\"attachment_120\" style=\"width: 710px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-120\" class=\"size-full wp-image-120\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/miopia-y-glaucoma-miopia.jpg\" alt=\"Explicaci\u00f3n miop\u00eda y glaucoma\" width=\"700\" height=\"200\" srcset=\"https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/miopia-y-glaucoma-miopia.jpg 700w, https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/miopia-y-glaucoma-miopia-300x86.jpg 300w\" sizes=\"(max-width: 700px) 100vw, 700px\" \/><p id=\"caption-attachment-120\" class=\"wp-caption-text\"><span class=\"notranslate\">a) Globus ocular de major longitud axial associat a alta miopia<\/span>\u00a0<br \/><span class=\"notranslate\">b) Globus ocular de mida normal<\/span><\/p><\/div>\n<h2><span class=\"notranslate\"><strong>MIOPIA: UN FACTOR DE RISC DE GLAUCOMA<\/strong><\/span><\/h2>\n<p><span class=\"notranslate\">Els estudis basats en la poblaci\u00f3 han demostrat que\u00a0<strong>les probabilitats de desenvolupar glaucoma augmenten amb l&#8217;augment de la gravetat de la miopia.<\/strong><\/span>\u00a0<span class=\"notranslate\">Aquesta relaci\u00f3 entre\u00a0<strong>miopia i glaucoma<\/strong>\u00a0es d\u00f3na perqu\u00e8, l&#8217;augment de la longitud de l&#8217;ull dels miops afecta el factor contribuent m\u00e9s important per al\u00a0<strong>desenvolupament del\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/glaucoma\/\" target=\"_blank\" rel=\"noopener noreferrer\">glaucoma<\/a>.<\/strong><\/span>\u00a0<span class=\"notranslate\">Els ulls d&#8217;una persona amb miopia ja presenten alteracions, causant una major fragilitat a nivell de les fibres nervioses que componen el nervi \u00f2ptic, el qual\u00a0<strong>\u00e9s mes susceptible als augments de pressi\u00f3 intraocular.<\/strong><\/span><\/p>\n<blockquote>\n<h4><a href=\"https:\/\/www.barnaclinic.com\/es\/cuadro-medico\/335\/elena-milla-grino\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-56\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/05\/elena-milla.png\" alt=\"\" width=\"120\" height=\"120\" \/><\/a><\/h4>\n<h4><span class=\"notranslate\"><strong>&#8220;Les probabilitats de desenvolupar glaucoma augmenten amb l&#8217;augment de la gravetat de la miopia&#8221;<\/strong><\/span><\/h4>\n<p>Dra.\u00a0<a href=\"https:\/\/www.barnaclinic.com\/ca\/quadre-medic\/335\/elena\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Elena Milla<\/strong><\/a><\/p><\/blockquote>\n<h2><\/h2>\n<h2><span class=\"notranslate\"><strong>HIPERMETROPIA I GLAUCOMA<\/strong><\/span><\/h2>\n<p><span class=\"notranslate\">Com hem dit a l&#8217;inici, la\u00a0<strong>miopia s&#8217;associa amb un augment de la prevalen\u00e7a del\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/tipus-glaucoma-caracteristiques-simptomes-i-causes\/\" target=\"_blank\" rel=\"noopener noreferrer\">glaucoma d&#8217;angle obert<\/a><\/strong>, mentre que\u00a0<strong>la hipermetropia s&#8217;associa amb una major prevalen\u00e7a de\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/tipus-glaucoma-caracteristiques-simptomes-i-causes\/\" target=\"_blank\" rel=\"noopener noreferrer\">glaucoma d&#8217;angle estret<\/a><\/strong>.<\/span>\u00a0<span class=\"notranslate\">L&#8217;ull del pacient amb hipermetropia \u00e9s (al contrari que en la miopia) de mida petita i, per tant, l&#8217;espai intraocular destinat al drenatge de l&#8217;humor aqu\u00f3s (l\u00edquid intraocular) es veu molt redu\u00eft, amb el risc que aquest l\u00edquid quedi retingut de manera brusca a l&#8217;interior de l&#8217;ull, causant una crisi de\u00a0<a href=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/ca\/tipus-glaucoma-caracteristiques-simptomes-i-causes\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>glaucoma agut<\/strong><\/a>.<\/span><\/p>\n<blockquote>\n<h4><a href=\"https:\/\/www.barnaclinic.com\/es\/cuadro-medico\/335\/elena-milla-grino\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-56\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/05\/elena-milla.png\" alt=\"\" width=\"120\" height=\"120\" \/><\/a><\/h4>\n<h4><span class=\"notranslate\"><strong>&#8220;La miopia s&#8217;associa amb un augment de la prevalen\u00e7a del glaucoma d&#8217;angle obert, mentre que la hipermetropia s&#8217;associa amb una major prevalen\u00e7a de glaucoma d&#8217;angle estret&#8221;<\/strong><\/span><\/h4>\n<p>Dra.\u00a0<a href=\"https:\/\/www.barnaclinic.com\/ca\/quadre-medic\/335\/elena\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Elena Milla<\/strong><\/a><\/p><\/blockquote>\n<h2><strong>DIAGN\u00d2STIC DEL GLAUCOMA A L&#8217;ULL MIOP<\/strong><\/h2>\n<p><span class=\"notranslate\">Les caracter\u00edstiques de l&#8217;ull miop anteriorment esmentades fan que\u00a0<strong>diagnosticar un glaucoma<\/strong>\u00a0en aquests ulls sigui en ocasions un repte per\u00a0<a href=\"https:\/\/www.barnaclinic.com\/ca\/quadre-medic\/335\/elena\" target=\"_blank\" rel=\"noopener noreferrer\">l&#8217;oftalm\u00f2leg<\/a>, sobretot a majors graus de miopia.<\/span><\/p>\n<p><span class=\"notranslate\">En primer lloc, l&#8217;avaluaci\u00f3 de la pressi\u00f3 intraocular (PIO) per si sola pot resultar ambigua per identificar el\u00a0<strong>glaucoma en pacients amb miopia alta<\/strong>\u00a0a causa del fet que la PIO dep\u00e8n significativament del gruix de la c\u00f2rnia.<\/span>\u00a0<span class=\"notranslate\">El gruix de la c\u00f2rnia varia segons el grup \u00e8tnic i \u00e9s caracter\u00edsticament prim als ulls miops (el que fa que siguin m\u00e9s propensos a un resultat negatiu per a l&#8217;elevaci\u00f3 de la PIO).<\/span>\u00a0<span class=\"notranslate\">Una dificultat afegida al\u00a0<strong>diagn\u00f2stic de glaucoma a l&#8217;ull miop<\/strong>\u00a0\u00e9s que molts d&#8217;aquests pacients han estat intervinguts de cirurgia refractiva mitjan\u00e7ant\u00a0l\u00e0ser excimer\u00a0(LASIK o PRK) a fi d&#8217;evitar l&#8217;\u00fas d&#8217;ulleres o lents de contacte.<\/span>\u00a0<span class=\"notranslate\">En aquest cas, el mesurament de la PIO resulta encara m\u00e9s enganyosa pel fet que aquesta cirurgia es realitza sobre la c\u00f2rnia, que \u00e9s l&#8217;estructura sobre la qual tamb\u00e9 es realitzen els mesuraments de PIO.<\/span><\/p>\n<p><span class=\"notranslate\">En segon lloc, els nervis \u00f2ptics de molts pacients amb\u00a0<strong>miopia alta<\/strong>\u00a0estan acompanyats de canvis com inclinaci\u00f3, aspecte torsional, atr\u00f2fia circumdant, etc.<\/span>\u00a0<span class=\"notranslate\">que fa que siguin m\u00e9s dif\u00edcils d&#8217;avaluar i de decidir si realment presenten canvis deguts al\u00a0<strong>glaucoma.<\/strong><\/span>\u00a0<span class=\"notranslate\">A m\u00e9s, aquestes alteracions es poden veure reflectides en les proves de\u00a0<strong>diagn\u00f2stic del glaucoma<\/strong>\u00a0com ara: el camp visual o la tomografia \u00f2ptica de refer\u00e8ncia, confonent els resultats.<\/span><\/p>\n<div id=\"attachment_123\" style=\"width: 308px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-123\" class=\"wp-image-123 size-medium\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-298x300.jpg\" alt=\"\" width=\"298\" height=\"300\" srcset=\"https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-298x300.jpg 298w, https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-150x150.jpg 150w, https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma.jpg 471w\" sizes=\"(max-width: 298px) 100vw, 298px\" \/><p id=\"caption-attachment-123\" class=\"wp-caption-text\">Fons d&#8217;ull esquerre que mostra un nervi \u00f2ptic (1), vasos sanguinis (2) i m\u00e0cula (3) de caracter\u00edstiques normals<\/p><\/div>\n<div id=\"attachment_124\" style=\"width: 310px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-124\" class=\"size-medium wp-image-124\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-miopia-300x221.jpg\" alt=\"\" width=\"300\" height=\"221\" srcset=\"https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-miopia-300x221.jpg 300w, https:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/10\/diagnostico-glaucoma-miopia.jpg 489w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><p id=\"caption-attachment-124\" class=\"wp-caption-text\">Fons d&#8217;ull d&#8217;un pacient amb miopia severa que mostra una gran atr\u00f2fia al voltant del nervi \u00f2ptic (1), atr\u00f2fia corio retiniana i alteracions vasculars (2) i alteracions maculars (3).<\/p><\/div>\n<h2 style=\"text-align: left;\"><\/h2>\n<hr \/>\n<h2><span class=\"notranslate\"><strong>MIOPIA I GLAUCOMA \u00c9S POSSIBLE LA CIRURGIA REFRACTIVA L\u00c0SER (LASIK O PRK)?<\/strong><\/span><\/h2>\n<p><span class=\"notranslate\">En el cas de\u00a0<strong>glaucomes moderats o severs,<\/strong>\u00a0NO \u00e9s recomanable realitzar aquesta cirurgia per tres motius fonamentals:<\/span><\/p>\n<ol>\n<li class=\"first\"><span class=\"notranslate\">A la\u00a0<strong>cirurgia LASIK<\/strong>\u00a0s&#8217;ha d&#8217;aplicar un anell de succi\u00f3 que causa durant uns segons un augment molt elevat de la PIO, amb el conseg\u00fcent risc que aix\u00f2 comporta per a un nervi \u00f2ptic ja danyat.<\/span><\/li>\n<li><span class=\"notranslate\">La cirurgia comporta un aprimament de la c\u00f2rnia i, per tant, com s&#8217;ha descrit anteriorment, un falsejament en els mesuraments de la PIO.<\/span><\/li>\n<li class=\"last\"><span class=\"notranslate\">Despr\u00e9s de la\u00a0<strong>cirurgia refractiva<\/strong>\u00a0s&#8217;ha d&#8217;utilitzar de manera perllongada col\u00b7liris amb corticoides que s\u00f3n f\u00e0rmacs que poden tamb\u00e9 causar un augment de la PIO.<\/span><\/li>\n<\/ol>\n<p><span class=\"notranslate\">En el cas de\u00a0<strong>hipertensions oculars<\/strong>\u00a0o\u00a0<strong>formes de glaucoma molt lleus,<\/strong>\u00a0s&#8217;ha d&#8217;estudiar cada cas individualment i, si no hi ha un altre tipus d&#8217;alteracions oculars i la PIO est\u00e0 completament estabilitzada, el pacient es pot sotmetre a aquest tipus de cirurgies.<\/span><\/p>\n<p><span class=\"notranslate\">Havent vist que hi ha una relaci\u00f3 directa entre\u00a0<strong>miopia i glaucoma,<\/strong>\u00a0\u00e9s fonamental que tots els pacients miops\u00a0<a href=\"https:\/\/www.barnaclinic.com\/ca\/solicitar-cita\/?profesional=335\" target=\"_blank\" rel=\"noopener noreferrer\">acudeixin al metge oftalm\u00f2leg almenys un cop l&#8217;any<\/a>\u00a0per tal de ser examinats en detall per descartar l&#8217;inici de la\u00a0<strong>patologia glaucomatosa.<\/strong><\/span>\u00a0<span class=\"notranslate\">Detectar de manera preco\u00e7 i comen\u00e7ar un\u00a0<strong>tractament anti-glaucomat\u00f3s<\/strong>\u00a0ser\u00e0 fonamental per frenar l&#8217;avan\u00e7 d&#8217;aquesta malaltia.<\/span><\/p>\n<blockquote>\n<h4><a href=\"https:\/\/www.barnaclinic.com\/es\/cuadro-medico\/335\/elena-milla-grino\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-56\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/05\/elena-milla.png\" alt=\"\" width=\"120\" height=\"120\" \/><\/a><\/h4>\n<h4><span class=\"notranslate\"><strong>&#8220;\u00c9s fonamental que tots els pacients miops acudeixin al metge oftalm\u00f2leg almenys un cop l&#8217;any per tal de ser examinats en detall per descartar l&#8217;inici d&#8217;un glaucoma&#8221;<\/strong><\/span><\/h4>\n<p>Dra.\u00a0<a href=\"https:\/\/www.barnaclinic.com\/ca\/quadre-medic\/335\/elena\" target=\"_blank\" rel=\"noopener noreferrer\"><strong>Elena Milla<\/strong><\/a><\/p><\/blockquote>\n<hr \/>\n<div id=\"estoy-interesado\" class=\"destacat-site\">\n<div class=\"row\">\n<div class=\"medium-8 columns title content\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" style=\"padding-left: 20px; padding-right: 10px; padding-top: 20px;\" src=\"http:\/\/www.barnaclinic.com\/blog\/oftalmologia\/wp-content\/uploads\/sites\/12\/2018\/05\/elena-milla.png\" width=\"90\" height=\"90\" \/><\/p>\n<h1 style=\"padding-left: 15px; padding-right: 15px;\" align=\"LEFT\"><span style=\"color: white;\">\u00bfQUIERE CONTACTAR CON LA DRA. ELENA MILLA?<\/span><\/h1>\n<p class=\"boto\" style=\"padding-left: 30px; padding-right: 20px;\" align=\"center\"><a class=\"button\" href=\"https:\/\/www.barnaclinic.com\/es\/solicitar-cita\/?profesional=335\" target=\"_blank&amp;\">PEDIR CITA<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>POST DEL DRA. ELENA MILLA La\u00a0miopia\u00a0\u00e9s la forma m\u00e9s comuna d&#8217;error de refracci\u00f3 ocular, afectant aproximadament 1.600 milions de persones a tot el m\u00f3n (que representen aproximadament el 22% de la poblaci\u00f3) i es preveu que augmenti la seva prevalen\u00e7a a 2.500 milions el 2020. L&#8217;associaci\u00f3 entre\u00a0miopia i\u00a0glaucoma\u00a0est\u00e0 ben establerta,\u00a0entre el\u00a06% i el 29% dels [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":134,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[70,65],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.14 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Miopia i glaucoma, estan relacionats? - Post de la Dra. 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