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Medical and surgical outcomes in childhood glaucoma: a population-based study
Elisabeth P Aponte1, Nancy Diehl, Brian G Mohney
1Mayo Clinic, College of Medicine, Rochester, Minnesota 55905, USA.
Insights
Pediatric glaucoma patients often require surgery, with many experiencing poor vision or eye loss. Medical management alone is rarely sufficient for controlling this condition in children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Glaucoma affects children, necessitating an understanding of long-term outcomes.
- Defined population studies are crucial for accurate epidemiological data.
Purpose of the Study:
- To describe clinical and surgical outcomes in patients under 20 with glaucoma.
- To analyze outcomes over a 40-year period in a defined population.
Main Methods:
- Retrospective review of medical records for patients diagnosed with glaucoma.
- Study population: Olmsted County, Minnesota, aged <20 years.
- Data collected from January 1, 1965, to December 31, 2004.
Main Results:
- Thirty children (45 eyes) diagnosed with glaucoma over 40 years.
- 60% underwent surgery; 20% had eye removal for blind, painful eyes.
- 37% had final visual acuity of 20/200 or worse; 10-year risk of vision loss was 22.7%.
Conclusions:
- Most pediatric glaucoma patients require surgical intervention.
- Medication alone is often insufficient for effective glaucoma control in children.
- Poor visual outcomes and eye loss are significant risks.
Introduction:
To describe the clinical and surgical outcomes among patients younger than 20 years of age diagnosed with glaucoma in a defined population during a 40-year period.
Methods:
The medical records of all patients (<20 years) diagnosed with glaucoma in Olmsted County, Minnesota, from January 1, 1965, through December 31, 2004, were retrospectively reviewed.
Results:
Thirty children (45 eyes) were diagnosed with various forms of glaucoma during the 40-year study period. During a mean follow-up of 12.5 years (range, 7 days to 32 years), 18 (60%) of the 30 children underwent a mean of 2.7 surgeries (range, 1 to 10), including 6 (20%) patients whose sole surgery consisted of enucleation or evisceration for a blind, painful eye. Twenty-eight (93%) of the 30 children required medical management during the follow-up period, including 14 (47%) treated before their first surgery. At the final follow-up examination, 11 (37%) had a visual acuity of 20/200 or worse. The 10-year Kaplan-Meier risk of vision decreasing less than 20/200 in all glaucoma patients was 22.7% (95% CI, 0-40.9), and patients requiring any glaucoma surgery was 68.3% (95% CI, 42.4-82.6).
Conclusions:
In this population-based study of children diagnosed with glaucoma during a 40-year period, most patients required surgery, with few being successfully controlled by medications alone. A poor visual outcome or the loss of an eye was relatively common.
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