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Lei Fang, Xing Liu, Yin Hu, Yi Min Zhong; Analysis of Visual Outcomes in Children with Primary Congenital Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1060.
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© ARVO (1962-2015); The Authors (2016-present)
Primary congenital glaucoma (PCG) is an important cause of children blindness. However, there is a paucity of information on visual outcome in PCG patients in China. This study aimed to evaluate the visual outcomes in children with PCG who underwent glaucoma surgery and to investigate the risk factors for vision loss.
This retrospective study included 45 PCG patients (73 eyes) with controlled intraocular pressure (IOP, ≤ 21 mmHg) after glaucoma surgery. The medical records, including demographic details, laterality, age at presentation, preoperative clinical findings, age at initial glaucoma surgery, type of initial glaucoma surgery, number of surgeries, antiglaucoma medication before initial surgery and at the last visit, and ocular comorbidity were collected. Clinical evaluations were performed in all PCG patients, including corrected visual acuity (VA), slit-lamp examination, fundus, IOP, cycloplegic refraction, fundus photography and optical coherence tomography. Best-corrected VA at last follow-up were categorized into 3 groups: good (20/20~20/50), moderate (<20/50~20/200), or poor (< 20/200). Univariate and multivariate analyses were performed to determine the risk factors for visual impairment (VA < 20/50).
The mean age at the last visit was 8.8 ± 4.5 years (range, 3 ~ 22 years). The demographic data and management of PCG patients was shown in Table 1. At last follow-up (median length after last surgery, 5.4 years), the mean IOP was 13.67 ± 3.94 mmHg; the mean LogMAR VA was 0.60 ± 0.62. A good VA was attained in 53.4%, moderate in 32.9%, and poor in 13.7%. The mean spherical equivalent of refraction was -4.09 ± 4.97 D; myopia was the predominant refractive error (50.0%). The most common ocular comorbidity was nystagmus (21.9%). Factors associated with vision impairment from univariate analysis were showed in Table 2; Multivariate Logistic regression analysis showed that multiple surgeries (≥ 2) (OR = 4.174, 95% CI: 1.269~13.723) was associated with VA impairment.
Good VA accounted for more than 50% of PCG eyes with controlled IOP following glaucoma surgery. Age at presentation, age at initial glaucoma surgery, and number of surgeries were associated with vision impairment, and multiple surgeries was the independent risk factor of vision impairment in PCG eyes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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