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Published on: October 1, 2007
Retrospective analysis of paediatric glaucoma at a tertiary referral centre in Hong Kong
Jonathan Cheuk-Hung Chan1, Shing Chuen Chow2, Jimmy Shiu-Ming Lai3
1Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Room 301, Block B, Cyberport 4, Hong Kong, People's Republic of China. jonochan@hku.hk.
Insights
In Hong Kong, most childhood glaucoma cases are secondary, not primary. Despite treatment, visual acuity often deteriorates, indicating a poorer prognosis for secondary pediatric glaucoma.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Childhood glaucoma presents unique epidemiological and clinical challenges.
- Understanding regional variations in pediatric glaucoma is crucial for targeted interventions.
- Hong Kong's specific demographic and healthcare landscape warrants investigation into its pediatric glaucoma cases.
Purpose of the Study:
- To analyze the epidemiological characteristics of pediatric glaucoma in Hong Kong.
- To document clinical interventions and their effectiveness in this population.
- To evaluate the visual outcomes and prognostic factors in children with glaucoma.
Main Methods:
- A retrospective chart review was conducted.
- Data from 33 pediatric glaucoma patients (under 18 years) diagnosed between 2008-2017 were analyzed.
- Demographics, etiology, interventions (tube-shunt surgery, transscleral cyclophotocoagulation), and outcomes were examined.
Main Results:
- Secondary glaucoma (78.8%) was more prevalent than primary glaucoma (21.2%).
- Juvenile-onset open-angle glaucoma and Sturge-Weber Syndrome-related glaucoma were common subtypes.
- Intraocular pressure was reduced post-intervention, but visual acuity deterioration was frequent.
Conclusions:
- Secondary pediatric glaucoma is predominant in Hong Kong, aligning with regions of low consanguinity.
- The high rate of secondary glaucoma correlates with poorer prognoses, frequent surgeries, and visual decline.
- Effective management strategies are needed to mitigate visual deterioration in pediatric glaucoma.
Purpose:
To evaluate the epidemiological features, clinical interventions, and outcomes of paediatric glaucoma in Hong Kong.
Study Design:
Retrospective chart review.
Methods:
Clinical data from the medical records of all patients under 18 years of age diagnosed with glaucoma from January 2008 to December 2017 at a university-affiliated, tertiary referral centre were collected. The patients' demographics, etiological distribution, clinical interventions, and outcomes were analysed.
Results:
A total of 33 subjects (53 eyes) were identified, 30 (49 eyes) of whom were Chinese. Primary glaucoma accounted for 21.2% of subjects, while 78.8% were diagnosed with secondary glaucoma. The most common subtype was juvenile-onset open angle glaucoma, followed by Sturge-Weber Syndrome related glaucoma. The most commonly performed surgical interventions were tube-shunt surgery (Ahmed Glaucoma Valve) and transscleral cyclophotocoagulation. Most eyes had significant reduction in intraocular pressure after medical or surgical intervention, but deterioration of visual acuity remained common.
Conclusion:
Most cases of childhood glaucoma in Hong Kong are secondary rather than primary, similar to other regions with low incidence of parental consanguinity. The large proportion of secondary glaucoma which generally has poorer prognosis, is reflected by the frequency of multiple surgery, and a high incidence of visual deterioration despite significant intraocular pressure reduction in most eyes.
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