Beyond Intraocular Pressure: Visual Functioning and Quality of Life in Primary Congenital Glaucoma and Secondary Childhood Glaucoma

Gothwal, Vijaya K.; Sharma, Sujata; Mandal, Anil K.

doi:10.1016/j.ajo.2019.09.002

Cited by 21 publications

(37 citation statements)

References 28 publications

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“…Recently, we published the results of VF and vision‐related QoL (VRQoL) of children aged 8–18 years treated for PCG and secondary childhood glaucoma at our centre (Gothwal et al. 2020). Similar VRQoL assessments in emerging and young adults treated for PCG in early childhood are, however, lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Given that the therapy is primarily surgical and that the majority are operated for PCG during infancy, their visual functioning (VF) and longevity of the surgical outcomes become important concerns. Recently, we published the results of VF and vision-related QoL (VRQoL) of children aged 8-18 years treated for PCG and secondary childhood glaucoma at our centre (Gothwal et al 2020). Similar VRQoL assessments in emerging and young adults treated for PCG in early childhood are, however, lacking.…”

Section: Discussionmentioning

confidence: 99%

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Combined trabeculotomy−trabeculectomy for primary congenital glaucoma: long‐term experience from a tertiary referral centre in a developing nation

Mandal

Gothwal

Khanna

2021

Acta Ophthalmologica

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Purpose: To evaluate the long-term visual and surgical outcomes, and associated risk factors for poor outcomes in patients with primary congenital glaucoma (PCG). Methods: Retrospective review of medical records of children who underwent combined trabeculotomyÀtrabeculectomy (CTT) without mitomycin-C as the first surgical procedure by a single surgeon between January 1990 and December 2010. Success was defined as intraocular pressure (IOP) <16 mmHg without (complete) or with (qualified) one glaucoma medication. We used the WHO criteria of vision loss to categorize the levels of vision impairment (VI). For purposes of statistical analysis, we randomly chose one eye of patients for bilateral PCG and affected eye in unilateral PCG. Results: The cohort included 653 consecutive PCG patients (1128 eyes; mean age, 26 months), of whom 475 (73%) underwent simultaneous bilateral CTT. Kaplan-Meier survival analysis revealed 1-, 5-, 10-, 15-, and 19-year complete success rates of 92.6% (n = 372), 75.5% (n = 173), 55.9% (n = 72), 44.7% (n = 19), and 21.6% (n = 3), respectively. Multivariate analysis revealed independent associations between failure, preoperative corneal clarity, and prior glaucoma surgery. Mean follow-up was 41 AE 51 months (range, 6 months to 19 years; median, 1 year). Of the visual acuity (VA) data in the affected eyes obtained at last follow-up (n = 333, 51%), seventy-four patients (22%) had VA of ≥6/12. Of the remaining 259 patients, 18 (7%) had mild VI, 87 (34%) had moderate VI, 58 (22%) had severe VI, and 96 (37%) were blind. No serious complications were noted. Conclusions: Primary CTT may be safely employed to control IOP and may provide long-term benefits in PCG patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Combined trabeculotomy−trabeculectomy for primary congenital glaucoma: long‐term experience from a tertiary referral centre in a developing nation

Mandal

Gothwal

Khanna

2021

Acta Ophthalmologica

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“…The best corrected VA was converted to logMAR for the purpose of analysis. If the VA was assessed as counting fingers, hand movements, perception of light, or no perception of light, then logMAR values of 2.1, 2.4, 2.7, and 3.0 were noted to indicate these, respectively [17]. Detailed slit-lamp findings, including corneal opacity and lens status, were recorded.…”

Section: Ocular Examinations and Data Collectionmentioning

confidence: 99%

Long-Term Visual Outcomes of Primary Congenital Glaucoma in China

Fang

Zhong

et al. 2022

Ophthalmic Res

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Introduction: To investigate the long-term visual outcomes and factors associated with vision loss in Chinese patients with primary congenital glaucoma (PCG) after successful intraocular pressure (IOP) control (IOP ≤ 21 mmHg). Methods: PCG patients with IOP control who were examined in the glaucoma clinic at Zhongshan Ophthalmic Center from 2019 to 2020 were enrolled. The final visual outcome was evaluated by the best-corrected visual acuity. Univariate and multivariate analyses were used to investigate the associations of visual impairment with potential risk factors. The causes for decreased visual acuity (VA, < 20/50) were also analyzed. Results: Fifty-nine patients (95 eyes) were included in the cohort, with a mean age of 8.7 years. The mean logMAR VA was 0.62 ±0.64. The VAs of eyes treated for PCG were good (≥20/50) in 56%, fair (20/60 to 20/200) in 30%, and poor (< 20/200) in 14%. The most common cause of decreased VA was amblyopia (64.3%). Multivariate logistic regression analysis showed that undergoing multiple surgeries (OR: 4.86, 95% CI: 1.11-21.16, P=0.035) was significantly associated with visual impairment. Conclusion: The results showed that good VA was attainable in approximately half of PCG eyes under IOP control. Prompt and effective treatment of PCG, management of amblyopia and ocular comorbidities may be potential steps toward achieving good visual outcomes in PCG patients.

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“…Nonetheless, several studies have reported that children with glaucoma who have lower best-corrected visual acuity (BCVA) experienced lower VR-QoL. [4][5][6][7] Meanwhile, a younger age has been associated with lower VR-QoL and HR-QoL. 7 8 However, there has been limited investigation as to why this trend was observed.…”

Section: Open Accessmentioning

confidence: 99%

Quality of life in children with glaucoma: a qualitative interview study in Australia

et al. 2022

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ObjectiveChildhood glaucoma is a chronic vision-threatening condition that may significantly impact an individual’s psychosocial well-being. There is a paucity of literature investigating the quality of life (QoL) in children with glaucoma. The aim of this study was to investigate and report on the QoL issues encountered by children with glaucoma.DesignThis is a qualitative interview study. Data were collected through semistructured interviews. NVivo V.12 software (QSR International Pty Ltd, Melbourne, Australia) was used to analyse and code data to identify QoL themes. The prominence of QoL themes was determined by the number of children who raised issues connected to the corresponding theme.SettingInterviews were conducted via telephone or videoconferencing between April 2020 and July 2021.ParticipantsEighteen children with glaucoma, aged 8–17 years, who resided in Australia, were recruited from the Australian and New Zealand Registry of Advanced Glaucoma.ResultsMedian child age was 12.1 years (IQR: 9.7–14.5 years) and 33% were female. Seven QoL themes were identified: ‘coping’, ‘inconveniences’ and ‘emotional well-being’ were more prominent themes than ‘symptoms’, ‘ocular health concerns’, ‘social well-being’ and ‘autonomy’. Adaptive coping strategies included resilience throughout clinical examinations and establishing positive relationships with ophthalmologists. These minimised inconveniences related to clinic waiting times and pupillary dilatation. External to the clinical setting, children often dissociated from their glaucoma but struggled with glare symptoms and feeling misunderstood by fellow peers. Older children aged 13–17 years commonly disengaged from their glaucoma care and expressed an unwillingness to attend ophthalmic appointments. Older children further raised issues with career options, obtaining a driver’s licence and family planning under the theme of autonomy.ConclusionsThe psychosocial impact of childhood glaucoma extends beyond the clinical environment and was minimised using coping strategies. Older children may require additional social and ophthalmic support as they transition into adulthood.

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Beyond Intraocular Pressure: Visual Functioning and Quality of Life in Primary Congenital Glaucoma and Secondary Childhood Glaucoma

Cited by 21 publications

References 28 publications

Combined trabeculotomy−trabeculectomy for primary congenital glaucoma: long‐term experience from a tertiary referral centre in a developing nation

Combined trabeculotomy−trabeculectomy for primary congenital glaucoma: long‐term experience from a tertiary referral centre in a developing nation

Long-Term Visual Outcomes of Primary Congenital Glaucoma in China

Quality of life in children with glaucoma: a qualitative interview study in Australia

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