Prognostic factors of pediatric glaucoma: a retrospective study

To correlate the features of certain types of infantile glaucoma with the progression and the prognosis of the disease, highlighting probable risk factors.

Seventy-six patients with pediatric glaucoma were recruited in this retrospective study. All patients underwent ophthalmological examination in the Department of Ophthalmology of the Saarland University Medical Center from January 2001 to December 2012. Our pediatric patients were classified into four different categories of glaucoma: (1) primary congenital glaucoma (presenting buphthalmus), (2) aniridia-related glaucoma, (3) Peters/Rieger's anomaly-related glaucoma and (4) congenital cataract-related glaucoma. Personal data comprised age, sex, nationality, systemic diseases and gestational age. The best-corrected visual acuity (BCVA), the cup-disk ratio (CDR), the intraocular pressure (IOP), the corneal diameter and thickness, along with the Haab striae and corneal haze, were recorded.

The majority of the children were male (58%) and suffered from aniridia-related glaucoma (38%). Children with aniridia exhibited the worst BCVA. The CDR and IOP were significantly higher in children with primary congenital glaucoma, compared to the other groups, at the first visit. Those children also were with the largest corneal diameter and prevalence of Haab striae compared to the rest groups, whereas corneal haze was found more often and was more pronounced in children with Peters/Rieger's syndrome.

We concluded that glaucoma was earlier detected in children with primary congenital glaucoma, who exhibited increased corneal diameter and high percentage of Haab striae comparing to the other groups. However, these children responded successfully to any therapeutic intervention, exhibiting better BCVA and IOP values than the rest groups at the second visit.