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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Visual outcomes and associated factors of primary congenital glaucoma in children
Haeng-Jin Lee1,2,3, Young Kook Kim4,5, Jin Wook Jeoung4,5
1Department of Ophthalmology, Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Insights
Maintaining good intraocular pressure and monitoring optic disc changes are key for better vision in children with primary congenital glaucoma. Early intervention improves long-term visual outcomes.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Primary congenital glaucoma (PCG) is a rare, severe form of glaucoma presenting at birth.
- Long-term visual outcomes in PCG patients are often challenging to predict and manage.
- Understanding factors influencing vision is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the long-term visual outcomes in children diagnosed with primary congenital glaucoma.
- To identify specific factors that correlate with final visual acuity in these patients.
Main Methods:
- Retrospective review of medical records for 44 patients (71 eyes) with PCG treated between 2005 and 2016.
- Minimum 3-year follow-up post-surgery; visual acuity (VA) categorized as good (≥20/70) or poor (<20/70).
- Analysis of factors including age, VA, refractive errors, intraocular pressure (IOP), laterality, and cup-to-disc (C/D) ratio.
Main Results:
- Mean follow-up was 6.7 years; 54.9% required occlusion treatment.
- Better visual outcomes were associated with lower IOP, fewer surgeries, optic disc cupping reversal, and better initial VA.
- At final assessment, 62.0% of eyes achieved a VA of ≥20/70, with a mean VA gain of 15.0 letters.
Conclusions:
- Intraocular pressure control and optic disc configuration are critical determinants of visual outcome in pediatric PCG.
- Regular monitoring, refractive error correction, and timely occlusion therapy can enhance visual results.
- Proactive management focusing on IOP and optic nerve health is essential for improving long-term vision in children with PCG.
Purpose:
We evaluated the long-term visual outcomes in children with primary congenital glaucoma and determined the factors associated with the final visual outcomes.
Methods:
Medical records of children with primary congenital glaucoma between 2005 and 2016, seen at Seoul National University Children's Hospital in South Korea, were reviewed. The minimum follow-up period after surgery for primary congenital glaucoma was 3 years. Visual acuity (VA) was categorized into good (≧20/70) and poor (< 20/70). Factors including age, VA, refractive errors, intraocular pressure (IOP), laterality, and cup-to-disc (C/D) ratio were compared between the groups.
Results:
A total of 71 eyes of 44 patients were included. The patients' age at the time of surgery was 14.7 ± 12.2 months. The mean IOP was 28.3 ± 7.0 mmHg. During 6.7 ± 2.7 years of mean follow-up after surgery, 39 eyes (54.9%) needed occlusion treatment. After occlusion, patients with lower IOP values, lesser additional surgeries, reversal of optic disc cupping, and better initially measured VA achieved a better visual outcome. At the final assessment, the mean age was 7.8 ± 2.6 years, and the mean VA gain was 15.0 ± 19.4 letters. There were 44 eyes (62.0%) with VA ≧20/70.
Conclusions:
In children with primary congenital glaucoma, IOP control and the optic disc configuration over time are important factors associated with visual outcome. Regular follow-up and correction of refractive errors-along with occlusion for those with difference in VA between the two eyes-might be helpful for achieving better visual outcomes.
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