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Zena Ibrahim, samiksha fouzdar jain, Dingcai Cao, Cem Mocan; Impact of glaucoma on visual prognosis in pediatric patients with Peters anomaly. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3625.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is frequently associated with Peters anomaly (PA) and may contribute to poor visual outcomes in this patient population. The aim of the study was to evaluate whether the presence of glaucoma adversely effects the recognition visual acuity (VA) in eyes of pediatric patients diagnosed with PA.
This was a retrospective study undertaken at a single university clinic setting. Clinical records of pediatric patients diagnosed with PA were included in the study. Type I PA was diagnosed when central or paracentral cornea opacities were isolated or associated with iridocorneal adhesions. Type II PA was diagnosed when corneal opacities were associated with keratolenticular adhesions. Presence of glaucoma was noted for each patient. VA results were converted to their logMAR equivalents. Generalized estimation equation (GEE) models, which can account between-eye correlations, were used to assess the impact of glaucoma on final visual acuity levels.
Twenty-one eyes of 11 (5F/6M) patients with a mean age of 5.7±9.9 months at presentation were analyzed. Among all patients, type I patients and type II patients had similar VA [1.36±0.88 in type I vs. 1.79±0.78 in type II, GEE: beta(se)=0.53(0.41), p = 0.196]. Glaucoma was present in 5/7 (71.4%) of type I PA patients and 4/4 (100%) of type II patients (Fisher’s exact test; p = 0.491). Among patients with glaucoma, type I PA patients had higher VA than type II patients [0.87±0.20 logMAR in type I vs. 1.79±0.78 logMAR in type II, GEE: beta(se)=1.25(0.25), p < 0.001]. Patients with glaucoma had with better visual outcomes in the entire sample studied [2.59±0.44 logMAR for non-glaucoma cases vs. 1.28±0.70 logMAR for glaucoma cases; beta(se)=-1.25(0.52), p = 0.017] and in type I patients [2.59±0.44 logMAR for non-glaucoma cases vs. 0.87±0.20 logMAR in glaucoma cases; beta(se)=-1.48(0.23), p <0.001]. Further GEE analysis that included both glaucoma and type of PA in a composite model indicated that both were significant factors affecting VA [Glaucoma: beta(se)=-1.53(0.30), p <0.001; type of PA: beta(se)=1.26(0.23), p <0.001].
In pediatric patients with Peters anomaly, type II anomaly, but not presence of glaucoma, appears to be associated with poor visual prognosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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