Long-Term Visual Outcomes of Primary Congenital Glaucoma in China

Abstract

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.

Long-Term Follow-up Results and Visual Outcomes of Childhood Glaucoma in the Black Sea Region of Turkey

“…After a mean followup of 84,2 months, 28,6% of participants had a VA of 20/50 or better. 4 reported that a VA of 20/50 and above was achieved in 56% of 95 eyes under IOP control. Our study found that 47,2% of the eyes had a VA of 20/50 or better in PCG.…”

“…Factors such as age at glaucoma diagnosis, differences in glaucoma etiology, and IOP control may explain this difference (GFCS participants had lower IOP at the initial and nal follow-up). Fang et al 4 suggested that preoperative HCD is related to low vision. However, we could not establish a relationship between HCD and low vision.…”

“…Many studies suggest that myopia is the most common refractive error in PCG patients. 4,8,17 Increased IOP is thought to cause axial elongation of the eye. 17 In our study, we found that myopia was the most common refractive error in PCG and secondary childhood cases (36,4% and 55%, respectively).…”

“…These ndings were consistent with previous literature. 4,8,18 Kargı et al 3 suggested that longterm control of IOP and keeping it below 19 mmHg may help preserve vision in patients with childhood glaucoma. Similar to our study, the authors suggested that amblyopia is the most common cause of low vision, and low vision was signi cantly higher in cases of aphakic glaucoma.…”

“…Visual prognosis differs in different geographic regions, and the proportion of eyes achieving good VA ranges from 26.9-79%. [3][4][5][6][7][8][9][10] Young age at diagnosis, unilateral disease, multiple surgeries, glaucomatous optic atrophy, and corneal opacity have been associated with poor visual prognosis for PCG. 8,10 The rst-line management strategy in the treatment of PCG is surgical treatment.…”