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Unrecognized ocular problems associated with port-wine stain of the face in children
Insights
Facial port-wine stains in children, a type of capillary hemangioma, may indicate glaucoma. Ocular exams revealed a 45% glaucoma risk when facial port-wine stains involve specific trigeminal nerve areas.
Area of Science:
- Ophthalmology
- Dermatology
- Pediatrics
Background:
- Port-wine stains are vascular malformations often affecting the face.
- In children, facial port-wine stains can be associated with ocular conditions like glaucoma.
- Early detection and management are crucial for preserving vision.
Purpose of the Study:
- To investigate the association between facial port-wine stains and glaucoma in pediatric patients.
- To determine if specific patterns of port-wine stain involvement correlate with glaucoma risk.
Main Methods:
- A cohort of 50 pediatric patients with facial port-wine stains underwent comprehensive ocular examinations.
- Facial areas were mapped based on trigeminal nerve (ophthalmic and maxillary divisions) sensory supply.
- Glaucoma was diagnosed based on intraocular pressure and visual field assessments.
Main Results:
- Glaucoma (true or suspect) was diagnosed in approximately 45% of patients whose port-wine stains involved facial areas supplied by both ophthalmic and maxillary trigeminal nerve divisions.
- No significant association with glaucoma was found when port-wine stains involved only one of these trigeminal nerve divisions.
Conclusions:
- Facial port-wine stains involving specific trigeminal nerve distributions in children are a significant risk factor for glaucoma.
- Ocular screening is recommended for pediatric patients with facial port-wine stains, particularly those with involvement of both ophthalmic and maxillary trigeminal nerve areas.
Abstract:
The port-wine stain, a relatively rare subgroup of capillary hemangiomas, usually involves the face and in children it may be associated with glaucoma. A series of 50 patients with facial port-wine stains had ocular examination at The Hospital for Sick Children, Toronto. When the facial areas supplied by both the ophthalmic and maxillary divisions of the sensory branch of the trigeminal nerve were involved (26 patients) there was about a 45% chance of diagnosing glaucoma, either as "true" glaucoma (with visual loss and raised intraocular pressure) or as "glaucoma suspect" (without visual loss). Involvement of the area supplied by either division alone was not associated with glaucoma.