Juvenile open angle glaucoma: current diagnosis and management

Ciociola, Elizabeth C.; Klifto, Meredith R

doi:10.1097/icu.0000000000000813

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…There are many surgical options for JOAG, with SLT, argon laser trabeculoplasty, trabeculectomy, deep sclerectomy, goniotomy, trabeculectomy, micro-invasive glaucoma surgery (MIGS), and glaucoma drainage devices being among the therapeutic lasers and surgical options used for the treatment of this condition. [1] Trabeculectomy is known to be effective in JOAG. Pathania et al [10] retrospectively reported the outcomes of trabeculectomy without mitomycin C augmentation in 60 eyes with primary JOAG.…”

Section: Discussionmentioning

confidence: 99%

“…JOAG is often refractory to medical therapy and frequently requires surgical interventions to achieve IOP control. [1,5] Surgical interventions in JOAG provide IOP control by facilitating aqueous humor outflow. [10] Trabeculectomy, angle surgery techniques such as goniotomy and trabeculotomy, minimally invasive glaucoma operations, and tube procedures are among the surgical interventions performed in JOAG.…”

mentioning

confidence: 99%

“…[10] Trabeculectomy, angle surgery techniques such as goniotomy and trabeculotomy, minimally invasive glaucoma operations, and tube procedures are among the surgical interventions performed in JOAG. [1] In this paper, we present our experiences with JOAG patients who underwent surgical interventions in our tertiary referral glaucoma center.…”

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confidence: 99%

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Surgical approaches to juvenile open-angle glaucoma

2024

Eur Eye Res

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To present the surgical options and surgical outcomes of juvenile open-angle glaucoma (JOAG). Methods: A retrospective review of the case series with JOAG that had undergone surgical treatment was undertaken. Surgical techniques, patient characteristics, and surgical outcomes were analyzed. Results: Thirteen eyes from eight patients with the diagnosis of JOAG were included in the study. The mean age was 26.77 ± 9.83 years. Five (62.5%) of the patients were male. The distribution of the operations was as follows: deep sclerectomy and external suture trabeculotomy in one eye (8%); Ahmed glaucoma valve implantation in one eye (8%); trabeculectomy with antimetabolite augmentation in five eyes (38%); and gonioscopy-assisted transluminal trabeculotomy (GATT) in six eyes (46%). The preoperative mean intraocular pressure (IOP) was 27.62 ± 7.17 mmHg, which decreased to 17.62 ± 13.06 mmHg at the last follow-up visit (36.21% decrease, P = 0.023, Wilcoxon rank test). IOP control was achieved without any additional surgical intervention in 10 (76.9%) eyes over the mean of 15.62 ± 12.17 months of the follow-up period. Further glaucoma surgery was required in three eyes, of which two had undergone GATT and one had undergone trabeculectomy as the primary surgery. Conclusion:The surgical treatment of JOAG results in IOP reduction, and more than one surgery may be required in some cases.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Surgical approaches to juvenile open-angle glaucoma

2024

Eur Eye Res

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“…Usually in this disease, medical management alone is insufficient, and many patients require surgical therapy for adequate IOP control. 11 This will prove a challenge in the mentally impaired, as eye rubbing must be avoided. Surgery was considered in our patient as well, but ultimately deferred due to concerns of eye rubbing and lack of visual potential.…”

Section: Discussionmentioning

confidence: 99%

A case of JOAG in a patient with Rett syndrome

Shaheen¹,

Fleischman²

2023

American Journal of Ophthalmology Case Reports

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“…Management of JOAG is challenging; often medical treatment is not effective. Surgical intervention is preferred as first-line management [3].…”

Section: Introductionmentioning

confidence: 99%

Tube Versus Trabeculectomy in Juvenile-Onset Open Angle Glaucoma – Treatment Outcomes in Tertiary Hospitals In Malaysia

Abd¹,

Ang²,

Raja³

et al. 2022

CSO

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Aim of the study: To compare the intraocular pressure (IOP) lowering effect and postoperative complications between primary augmented trabeculectomy and glaucoma drainage device (GDD) implantation as primary surgical intervention in patients with juvenile-onset open angle glaucoma (JOAG). Patients and Methods: A retrospective review study involving 20 eyes that underwent primary augmented trabeculectomy with mitomycin (MMC) and 10 eyes GDD implantation in 3 tertiary centres in Malaysia between 1 January 2013 and 31 December 2019. They were followed up for at least 12 months postsurgical intervention. Intraocular pressure (IOP), number of topical IOP lowering medication and complications were evaluated at 1, 3, 6 and 12 months post-intervention. Based on the IOP, the success was divided into complete and partial success, and failure. IOP and postsurgical complications were compared using the Repetitive Measure Analysis of Variance (RM ANOVA) and the Pearson chi-square test. Results: Both methods were effective in lowering the IOP. Eyes with primary augmented trabeculectomy have significant lower IOP compared to GDD implantation (p = 0.037). There was a higher incidence of postoperative hypotony (30%) in the trabeculectomy group. There was also a significant reduction of mean number of topical pressure-lowering drugs required postoperatively (p = 0.015). Complete success was achieved in 100% of eyes with trabeculectomy and 67% in GDD implantation (p = 0.047). Conclusions: Primary augmented trabeculectomy and GDD implantation are good surgical options for the treatment of JOAG. Both methods provide IOP lowering at 1 year. However, trabeculectomy provides better pressure lowering, compared to GDD implantation in patients with JOAG.

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Juvenile open angle glaucoma: current diagnosis and management

Cited by 9 publications

References 33 publications

Surgical approaches to juvenile open-angle glaucoma

Surgical approaches to juvenile open-angle glaucoma

A case of JOAG in a patient with Rett syndrome

Tube Versus Trabeculectomy in Juvenile-Onset Open Angle Glaucoma – Treatment Outcomes in Tertiary Hospitals In Malaysia

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