Aim: To describe the clinical and epidemiological characteristics of children with pediatric glaucoma (PG) treated in an ophthalmologic national reference center.
Materials and methods: A retrospective study of patients diagnosed with PG in a national ophthalmologic reference center was made, between 2005 and 2015. Clinical findings, type of treatment, and the follow-up were evaluated.
Results: A total of 89 patients (145 eyes) were included. The median age of diagnosis was 2.0 years. The most frequent type of glaucoma was primary PG with 67.4% of affected patients, primary congenital glaucoma (PCG) being more frequent (69 eyes) than juvenile open-angle glaucoma (JOAG 36 eyes). Secondary PG accounted for 32.6% of the cases (40 eyes). At least one surgical procedure was needed in 56.6% of all studied eyes, and 10.7% of eyes had more than two surgical procedures. Even more, eyes with PCG had surgery in 88.4% of cases. On the contrary, eyes with JOAG did not require surgery. In the last assessment, the distribution of cases according visual acuity did not show differences. However, it is important to note that patients with secondary PG maintained a good vision only in 17.9% of cases.
Conclusion: Pediatric glaucoma is a heterogeneous group of diseases, and due to its low incidence, descriptive reports of large cohorts are not available. This study has a well-detailed report of PG characteristics in a national reference center. The frequency of JOAG in the present study was significantly higher than that reported in other studies. Also, clinical characteristics of all glaucoma described have some differences from data published.
Clinical significance: There are few studies that describe characteristics of PG. This study is an important tool to analyze the characteristics of PG in an effort to better know the disease.
Hoguet A, Grajewski A, Hodapp E, et al. A retrospective survey of childhood glaucoma prevalence according to childhood glaucoma research network classification. Indian J Ophthalmol 2016;64(2):118. DOI: 10.4103/0301-4738.179716.
Moore DB, Tomkins O, Ben-Zion I. A review of primary congenital glaucoma in the developing world. Surv Ophthalmol 2013;58(3):278–285. DOI: 10.1016/j.survophthal.2012.11.003.
Taylor RH, Ainsworth JR, Evans AR, et al. The epidemiology of pediatric glaucoma: the Toronto experience. J AAPOS 1999;3(5):308–315. DOI: 10.1016/s1091-8531(99)70028-5.
Montezuma SR, Serrano JC. Glaucoma Pediátrico en la Fundación Oftalmológica de Santander. Bucaramanga (Santander): MEDUNAB; 1999. pp. 5–13.
Papadopoulos M, Cable N, Rahi J, et al. Study investigators. The British infantile and childhood glaucoma (BIG) eye study. Invest Ophthalmol Vis Sci 2007;48(9):4100–4106. DOI: 10.1167/iovs.06-1350.
Abdolrahimzadeh S, Fameli V, Mollo R, et al. Rare diseases leading to childhood glaucoma: Epidemiology, pathophysiogenesis, and management. Biomed Res Int 2015;2015:781294. DOI: 10.1155/2015/781294.
Weinreb R, Papadopoulos M, Grigg J. Childhood glaucoma - World glaucoma association consensus series 9. Kugler Publ; 2013.
Lonngi M, Aguilar MC, Ríos HA, et al. Pediatric uveitis: experience in Colombia. Ocul Immunol Inflamm 2016(4):1–5. DOI: 10.3109/09273948.2016.1160129.
Sinha G, Patil B, Sihota R, et al. Visual field loss in primary congenital glaucoma. J Am Assoc Pediatr Ophthalmol Strabismus 2015;19(2):124–129. DOI: 10.1016/j.jaapos.2014.12.008.
Zagora SL, Funnell CL, Martin FJ, et al. Primary congenital glaucoma outcomes: lessons from 23 years of follow-up. Am J Ophthalmol 2015;159(4):788–796. DOI: 10.1016/j.ajo.2015.01.019.
de Silva DJ, Khaw PT, Brookes JL. Long-term outcome of primary congenital glaucoma. J Am Assoc Pediatr Ophthalmol Strabismus 2011;15(2):148–152. DOI: 10.1016/j.jaapos.2010.11.025.
Fung DS, Roensch MA, Kooner KS, et al. Epidemiology and characteristics of childhood glaucoma: results from the Dallas glaucoma registry. Clin Ophthalmol 2013;7:1739–1746. DOI: 10.2147/OPTH.S45480.
Aponte EP, Diehl N, Mohney BG. Medical and surgical outcomes in childhood glaucoma: a population-based study. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus 2011;15(3):263–267. DOI: 10.1016/j.jaapos.2011.02.015.
Khalil DH, Abdelhakim MASE. Primary trabeculotomy compared to combined trabeculectomy-trabeculotomy in congenital glaucoma: 3-year study. Acta Ophthalmol 2016;94(7):e550–e554. DOI: 10.1111/aos.13018.
Cup-to-Disc Ratio - an overview | ScienceDirect Topics [Internet]. [cited 2019 May 30]. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/cup-to-disc-ratio.
Jalil A, Au L, Khan I, et al. Combined trabeculotomy-trabeculectomy augmented with 5-fluorouracil in paediatric glaucoma. Clin Exp Ophthalmol 2011;39(3):207–214. DOI: 10.1111/j.1442-9071.2010.02444.x.
Liu D, Huang L, Mukkamala L, et al. The economic burden of childhood glaucoma. J Glaucoma 2016;25(10):790–797. DOI: 10.1097/IJG.0000000000000412.