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Visual Field Progression in Childhood Glaucoma Versus Open-Angle Glaucoma: A Retrospective Comparative Study.

Ainhoa Colina-Jareno1, Ruben Sanchez-Jean1, Irene Serrano-Garcia2

  • 1Ophthalmology Department, Hospital Clinico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain.

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Summary

Childhood glaucoma shows slower visual field deterioration than open-angle glaucoma (OAG), with similar progression timing. Baseline visual field status is the key predictor of long-term outcomes in both groups.

Keywords:
childhood glaucomalong-term outcomesmean defectopen-angle glaucomaregression analysissurvival analysisvisual field progression

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Visual Field Analysis

Background:

  • Limited evidence exists on long-term visual field progression in childhood glaucoma versus adult open-angle glaucoma (OAG).
  • Understanding progression rates and predictors is crucial for effective management of pediatric and adult glaucoma.

Purpose of the Study:

  • To compare the rate and timing of visual field progression between childhood glaucoma and OAG.
  • To identify predictors of final visual field status in these patient groups.

Main Methods:

  • Retrospective observational study of 171 eyes (87 childhood glaucoma, 84 OAG) with ≥3 visual field tests and ≥2 years follow-up.
  • Visual fields assessed using Octopus perimeter (G grid, TOP strategy); progression evaluated by mean defect (MD) rate (dB/year).
  • Statistical analyses included Mann-Whitney U test, Kaplan-Meier, restricted mean survival time (RMST), Cox models, and multiple linear regression.

Main Results:

  • Childhood glaucoma had worse baseline MD and higher surgery rates; OAG used more medications.
  • Median MD progression rate was -2.3 dB/year in childhood glaucoma vs. 0.0 dB/year in OAG (p < 0.001), indicating slower deterioration in pediatric cases.
  • Progression-free survival and timing to first progression were similar between groups; baseline MD was the strongest predictor of final MD.

Conclusions:

  • Visual field deterioration appears slower in childhood glaucoma compared to OAG, despite worse baseline status.
  • Current management strategies may contribute to functional stability in childhood glaucoma.
  • Individualized follow-up and timely intervention are recommended, particularly for pediatric glaucoma patients.