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Clinical Course and Predictors of Glaucoma Conversion in Pediatric Ocular Hypertension without Ocular or Systemic
Meron Haile1, Nur Cardakli1, Catherine S Yao1
1The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street Baltimore, Maryland, USA.
Ophthalmology. Glaucoma
|July 28, 2026
Summary
Pediatric ocular hypertension carries a risk of glaucoma conversion, with higher baseline intraocular pressure (IOP), larger cup-to-disc ratio (CDR), and male sex being key predictors. These factors guide risk stratification for personalized monitoring and treatment in children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Background:
- Pediatric ocular hypertension (OHTN) without risk factors requires long-term outcome characterization.
- Identifying predictors of glaucoma conversion is crucial for timely intervention.
Purpose of the Study:
- To analyze the long-term clinical course of pediatric OHTN.
- To identify predictors of glaucoma conversion in this population.
Main Methods:
- Retrospective cohort study of pediatric patients with OHTN.
- Inclusion criteria: age <18, intraocular pressure (IOP) >21 mmHg, ≥180 days follow-up, no risk factors.
- Multivariable logistic regression used to identify conversion predictors.
Main Results:
- 8.7% of eyes converted to glaucoma over a mean follow-up of 7.1 years.
- Higher baseline IOP, larger cup-to-disc ratio (CDR), and male sex were associated with conversion.
- Male sex (aOR 3.19), higher baseline IOP (aOR 1.12/mmHg), and larger baseline CDR (aOR 1.32/0.1) predicted conversion.
Conclusions:
- Isolated pediatric OHTN is not benign and has a significant risk of glaucoma conversion.
- Baseline IOP, CDR, and male sex are important factors for risk stratification.
- Individualized surveillance and early treatment are recommended for high-risk children.
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