Visual field loss in primary congenital glaucoma.

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Glaucoma Research

Background:

• Primary congenital glaucoma (PCG) is a rare but severe form of glaucoma.
• Visual field defects are a primary indicator of glaucoma progression.
• Understanding risk factors for visual field loss in PCG is critical for timely intervention.

Purpose of the Study:

• To evaluate visual field impairments in patients with primary congenital glaucoma (PCG).
• To identify key risk factors associated with visual field defects in PCG.
• To correlate visual field outcomes with age at detection and baseline intraocular pressure (IOP).

Main Methods:

• A cross-sectional study involving 100 eyes of 77 PCG patients.
• Visual fields assessed using Humphery Field Analyzer (HFA) or Goldmann visual field (GVF).
• Analysis of mean deviation, pattern standard deviation (PSD), foveal threshold, and global visual field extent in relation to baseline IOP and age at detection.

Main Results:

• PCG detected at ≤1 month showed significantly lower visual field parameters compared to later detection.
• Higher baseline intraocular pressure (>30 mm Hg) was associated with significantly reduced visual field extent and severity.
• Arcuate scotoma was the most common glaucomatous defect, observed in 22% of eyes.

Conclusions:

• Early diagnosis of PCG (≤1 month) is linked to greater visual field loss.
• Elevated baseline intraocular pressure (>30 mm Hg) in PCG patients predicts more severe visual field impairment.
• These findings underscore the importance of early detection and aggressive management of IOP in PCG.