Abstract
Purpose :
Congenital glaucoma (CG) is an uncommon condition but of major relevance due to the visually disabling effect it can have on infant or newborn patients, if not detected early and treated appropriately. The treatment of CG is primarily surgical, requiring long-term follow-up to ensure visual stability throughout the lives of affected patients. The aim of this study is to assess the clinical long-term outcomes of congenital glaucoma in patients followed for more than five years.
Methods :
A retrospective analysis was conducted using the information contained in 207 electronic medical records of patients diagnosed with congenital glaucoma at a specialized center located in the west of Mexico. Records that included complete clinical information for at least 5 years were included. The variables included were the age of diagnosis, general health history, history of eye surgery, use of antiglaucoma medications, initial intraocular pressure (IOP), IOP available throughout their follow-up at annual intervals, IOP of the last visit, initial and final best corrected visual acuity, as well as optic disc characteristics. In the statistical analysis, a p-value of less than 0.05 was considered significant.
Results :
Eighty-nine eyes from 54 patients were included among which there were more female (52.8%), eyes with myopia (66.3%), and with a history of angle surgery (96.6%). Twenty-eight cases (31.4%) required subsequent eye surgery. The mean age was 27.5 ± 13.9 (range, 5-63) years. Mean follow-up was 7.3 ± 4 years (range, 5-11 years). At the first clinical assessment, mean IOP was 17.4 ± 7.6 mm Hg (range, 5-42) and mean cup/disc ratio was 0.68 ± 0.37). At the last clinical evaluation, mean IOP was 14.9 ± 5.6 mm Hg (range, 4-23; p = 0.03) and mean cup/disc ratio was 0.73 ± 0.32 (p = 0.41). Follow up assessment demonstrated visual stability in 90.3% at 1 year, 84.3% at 5 years, 77.5% at 6 years, 51.7% at 7 years, and 29.2% at 8 years. About two-thirds of the eyes whose vision deteriorated had the highest IOPs associated with more severe structural changes in the anterior segment. A total of 16 eyes (17.9%) developed blindness attributable to the glaucoma itself.
Conclusions :
In the long-term follow-up of patients with congenital glaucoma, visual deterioration can be due not only to glaucoma, but also to other different causes, which makes it necessary to develop strategies for earlier diagnosis with highly specialized management.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.