Long-term structural and functional outcomes of primary congenital glaucoma

Hsia, Yun; Lai, Tso‐Ting; Su, Chien‐Chia; Wang, Tsing-Hong; Huang, Jehn-Yu

doi:10.1007/s00417-021-05185-1

Cited by 3 publications

(7 citation statements)

References 37 publications

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“…Worst eye was defined as worst mean defect on automated perimetry, subsequently worst pRNFL, subsequently worst VA. (a) There were 44 patients that had at least one eye with valid autoperimetry data that were included in this analysis. of VA, VF and pRNFL (Hsia et al, 2021). This group found a MD of 4.7 dB using Humphrey Field Analyzer and a mean pRNFL of 71.6 μm across all ages using Cirrus OCT. To our knowledge this is the only other study that has reported on both VA, VF and pRNFL collectively for PCG.…”

Section: Discussionmentioning

confidence: 68%

Long‐term functional and structural outcomes in patients with primary congenital glaucoma—A Danish nationwide study

Brynskov,

Bach‐Holm,

Kappelgaard

et al. 2023

Acta Ophthalmologica

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PurposeEvaluation of long‐term functional and structural outcomes in patients with primary congenital glaucoma (PCG) based on visual acuity (VA), visual field (VF) using standard automated perimetry, and peripapillary retinal nerve fibre layer thickness (pRNFL).MethodsWe retrospectively reviewed medical records of all patients diagnosed with PCG in Denmark from 1977 to 2016. Severe vision loss was defined as VA <6/60 and/or VF >20 decibels (dB). Prognostic factors were evaluated in a correlation matrix.ResultsThe median age of the 94 patients (153 PCG eyes) was 12 years (IQR 9–16). In PCG eyes 62% had VA ≥6/18 but 22% had <6/60. VA in the better seeing eye was ≥6/18 in 90% and <6/60 in 5%. VF was measured in 59 PCG eyes and the median mean defect was 5.1 dB (IQR 2.1–9.6) with 52% better than 6 dB and 9% worse than 20 dB. Generalized pRNFL was reduced below the age‐expected 1st percentile in 29% of the 58 PCG eyes where pRNFL was measured. Poor VA, poor VF and reduced pRNFL were all correlated (p = 0.0001). More surgeries (p < 0.0001) and longer diagnostic delay (p = 0.004) were associated with poorer vision and to a lesser degree with poor VF pRNFL.ConclusionIn Denmark, most patients with bilateral PCG retain VA ≥6/18 in the better seeing eye. Poor VA was associated with poor VF. Longer diagnostic delay and more surgeries were associated with a poorer prognosis.

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Section: Discussionmentioning

confidence: 68%

Long‐term functional and structural outcomes in patients with primary congenital glaucoma—A Danish nationwide study

Brynskov,

Bach‐Holm,

Kappelgaard

et al. 2023

Acta Ophthalmologica

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“…On multivariable regression analysis, Hsia et al . [ 11 ] found that only inter-visit fluctuation IOP was significantly associated with OCT progression and higher average IOP was associated with VF progression. Our study found that RNFL loss was significantly different in all quadrants except nasal between PCG eyes with VF defects and PCG eyes with normal VFs.…”

Section: Discussionmentioning

confidence: 99%

“…Hsia et al . [ 11 ] found these two factors responsible for structural progression on OCT in PCG eyes over time as well. A mean RNFL thickness of 100 μm, with the superior and inferior quadrant being thickest, was recorded by Srinivasan et al .…”

Section: Discussionmentioning

confidence: 99%

“…Operated PCG eyes in our study had significantly reduced final visual acuity as compared to normal eyes, also noted by other studies. [ 7 11 12 27 ] Dahlman-Noor et al . [ 28 ] noted a reduced functional visual ability (FVA) in children with glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…However, in young children, identifying the extent of visual field loss or continued progression of glaucomatous loss is currently not possible by perimetry, even though it is imperative for appropriately adjusting target IOP and for further management. Several studies have shown structural and functional abnormalities with time domain optical coherence tomography (TD-OCT),[ 7 8 9 10 ] spectral domain OCT[ 11 12 13 ] and visual field (VF)[ 11 14 ] in older children, some similar to adults. [ 15 16 ] The introduction of handheld OCT during examination under anesthesia or in younger children who can fix during an OCT examination could provide an objective evaluation, if parameters associated with visual field loss are known.…”

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confidence: 99%

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Evaluation of visual field changes with retinal nerve fiber layer thickness in primary congenital glaucoma

Naik

Sihota

Mahalingam

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To evaluate visual field changes in primary congenital glaucoma (PCG) with retinal nerve fiber layer thickness on optical coherence tomography. Methods: In this cross-sectional, observational study, consecutive PCG children who underwent combined trabeculotomy with trabeculectomy and on regular follow-up were enrolled. All patients were aged over four years and co-operative for RNFL OCT and visual field examination. Perimetry was done on Humphrey visual field (HVF) analyzer using 30-2 and 10-2 SITA standard algorithms as appropriate. If a reliable automated perimetry was not feasible, kinetic perimetry was done. The following were noted at baseline and every follow-up: age, sex, visual acuity, intraocular pressure (IOP), cup–disc ratio (CDR), corneal diameters, refraction, any topical antiglaucoma medications, surgeries underwent, age at surgery and duration between surgery and final examination. Results: Forty-eight eyes of 34 children operated for PCG and 19 eyes of 17 controls were analyzed. A statistically significant thinner average RNFL thickness of 87.2 ± 28 μm was noted in PCG eyes as compared to controls with 100.6 ± 7.2 μm ( P = 0.04). The mean cup–disc area ratio on OCT in PCG eyes was 0.43 ± 0.2 (0.02–0.93) and in control eyes was 0.23 ± 0.07 (0.1–0.4) ( P < 0.001). On RNFL OCT, there was significant focal RNFL loss in temporal superior ( P = 0.003), nasal inferior ( P = 0.037) and temporal inferior ( P < 0.001) quadrants compared to controls. Among PCG eyes, 20/48 eyes (41.7%), had definitive, reproducible glaucomatous VF defects. Mean baseline IOP in PCG eyes with VF defect was 28.7 ± 5.7 mmHg and in eyes with normal VF was 24.6 ± 5.9 mmHg ( P = 0.03). On univariate regression analysis, higher baseline IOP was significantly associated with both RNFL loss (odds ratio (OR): −2.17) and VF defects (OR: 3.35). Fluctuation in follow-up IOP (OR: 3.33) was also significantly associated with the presence of VF defects. On multivariable regression analysis maximum, IOP was significantly associated with RNFL loss and VF defects. Conclusion: Peripapillary RNFL thickness could be used to identify PCG eyes having visual field loss and possibly poor visual function from PCG eyes without visual field defects. Baseline and follow-up IOP, significantly correlated with RNFL thickness in PCG eyes.

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Chromatic vision and structural assessment in primary congenital glaucoma

Kato,

Rolim-de-Moura,

Allemann

2024

Sci Rep

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Primary congenital glaucoma is a rare disease that occurs in early birth and can lead to low vision. Evaluating affected children is challenging and there is a lack of studies regarding color vision in pediatric glaucoma patients. This cross-sectional study included 21 eyes of 13 children with primary congenital glaucoma who were assessed using the Farnsworth D-15 test to evaluate color vision discrimination and by spectral domain optical coherence tomography to measure retinal fiber layer thickness. Age, visual acuity, cup-to-disc ratio and spherical equivalent data were also collected. Global and sectional circumpapillary and macular retinal fiber layer thicknesses were measured and compared based on color vision test performance. Four eyes (19%) failed the color vision test with diffuse dyschromatopsia patterns. Only age showed statistical significance in color vision test performance. Global and sectional circumpapillary and macular retinal fiber layer thicknesses were similar between the color test outcomes dyschromatopsia and normal. While the color vision test could play a role in assessing children with primary congenital glaucoma, further studies are needed to correlate it with damage to retinal fiber layer thickness.

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Long-term structural and functional outcomes of primary congenital glaucoma

Cited by 3 publications

References 37 publications

Long‐term functional and structural outcomes in patients with primary congenital glaucoma—A Danish nationwide study

Long‐term functional and structural outcomes in patients with primary congenital glaucoma—A Danish nationwide study

Evaluation of visual field changes with retinal nerve fiber layer thickness in primary congenital glaucoma

Chromatic vision and structural assessment in primary congenital glaucoma

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