Epidemiological pattern of Primary Congenital Glaucoma among Egyptian Children aged 0-4 years Attending Minoufia University hospital

Abstract

Background: Congenital Glaucoma (CG) is a multiple disease features that can lead to loss of vision. Unfortunately, studies involved in the detection of Primary Congenital Glaucoma (PCG) in Egypt are not enough. Delayed diagnosis and management in those patients consequently lead to burdens on patients and their families.Objectives: To Assess the frequency of CG among children aged 0 to 4 years during the period from 2017-2020٠ attending Menoufia hospital and primary congenital glaucoma regarding its demographic data, associated risk factors and the used surgical modalities.Methods: A retrospective cohort study was conducted on children with congenital glaucoma aged 0-4 years, presented to out-patient clinics at ophthalmic and pediatrics departments in Menoufia University hospitals during the period from 2017 to 2020.Results: Incidence of glaucoma among the suspected cases was 65.8 per 100,000 cases during the 4 years. Conjunctivitis, Nasolacrimal Duct Obstruction (NLDO), and corneal abrasion were among the highest incidence that contributed to confusion with the diagnosis of PCG comprising 526.3, 394.7, and 78.95 per 100,000, respectively. Eighty-two percent of the cases had positive consanguineous marriage that contributed to the higher incidence of PCG among other gypsies. Positive family history of PCG was detected only in 20% of the cases. Axenfeld-Rieger syndrome was presented only in 1 case. Bilateral PCG comprised 84% of the total cases. Visual acuity was mostly managed either by fix and follow or poor fixation in 42 % and 56 % of the cases, respectively.Seven cases only experienced post-operative complications between hypotony, choroidal hypotony, or uncontrolled Intraocular Pressure (IOP). 32% of the cases gained visual acuity problems and the rest suffered non Conclusion: PCG comprised high incidence in the cases presented to the outpatients' clinics as consanguineous marriage was remarkable in those cases. Most of the cases had classic trabeculectomy followed by equal percentage of both goniotomy and combined trabeculectomy-trabeculectomy (CTT). Secondary surgical management involved CTT and combined trabeculectomy with Ahmed valve. All the three measurement to assess post-surgical success rates were significantly differ whether IOP, cup diameter, or corneal diameter.