Pediatric glaucoma suspects

Abstract

PurposeTo report demographic and ocular features of pediatric glaucoma suspects in an ethnically diverse population of North Central Texas.DesignRetrospective cross-sectional chart review.ParticipantsSubjects included 75 (136 eyes) pediatric glaucoma suspects. Patients with one or more of the following risk factors were included: cup-to disc (C/D) ratio of ≥0.6; intraocular pressure (IOP) ≥21 mmHg; family history of glaucoma; congenital glaucoma in the opposite eye; history of blunt trauma to either eye; and presence of either Sturge-Weber or Axenfeld–Rieger syndrome, or oculodermal melanocytosis.MethodsData were extracted from electronic patient medical records. Patient records with incomplete data were excluded. The main outcome measures were race, sex, age, IOP, C/D, family history of glaucoma; and glaucoma treatment.ResultsSubjects included 28 (37.3%) Hispanics, 20 (26.6%) African Americans, 20 (26.6%) Caucasians, and seven (9.3%) Asians. Forty (53.3%) of the patients were male. Suspicious optic disc was seen in 57 (76%); elevated IOP in 25 (33.3%); presence of family history in 13 (17.3%), and Sturge–Weber syndrome in nine (12%) patients. The average C/D ratio was 0.58±0.2. The C/D ratios of African American (0.65±0.2), Hispanic (0.63±0.2), and Asian (0.62±0.15) patients were significantly greater than those of Caucasians (0.43±0.18; P=0.0004, 0.0003, and 0.0139, respectively). Caucasian patients were the youngest (7.9±4.8 years). Eleven cases (14.7%) required medication.ConclusionThirty-three point seven percent of patients seen in the glaucoma clinic were glaucoma suspects. The most common risk factors for suspected glaucoma were suspicious optic discs, elevated IOP, and family history of glaucoma. Most patients required only close observation. Long-term follow-up of these patients is warranted to determine the mechanisms of conversion to glaucoma.

Characteristics and long-term outcomes of childhood glaucoma: a retrospective-cohort study

“…Leukocoria or corneal haze were the leading presenting symptom in PCG (46.9%) and SCG-O (77%) similar with previous studies [16][17][18] . Moreover, most patients with JOAG were diagnosed without any symptoms.…”

“…High IOP was the leading clue for glaucoma diagnosis. Furthermore, an enlarged corneal diameter was considered an important sign of PCG 16 .…”

Effect of airway device and depth of anesthesia on intra-ocular pressure measurement during general anesthesia in children

“…[ 14 ] Regular accurate assessment and long term follow up is very much essential in patients with high risk factors like suspicious optic discs, cup-to disc (C/D) ratio of ≥0.6, asymmetry more than 0.2 between the two eyes, narrow neuroretinal rim, persistently elevated IOP of ≥21 mmHg, family history of glaucoma in the parents or sibling, diagnosis of congenital glaucoma in the other eye, history of blunt trauma to either eye and conditions associated with glaucoma such as Sturge-Weber syndrome or Axenfeld-Rieger syndrome. [ 15 ] In the current study, measured IOP value is found to vary with the depth of anesthesia. Therefore, accurate IOP assessment under targeted optimum depth of anesthesia with BIS monitoring can be justified in certain selected high-risk population, where management depends on the accuracy of measured IOP.…”

Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children

“…However, as mentioned above, few studies have investigated IOP in children, while research has been mainly focused on the adult population, albeit with contrasting findings [4-6]. Studies performed in children were designed and conducted with varying methodologies with regard to children’s eye diseases, mainly conducted in patients with suspected pediatric glaucoma [32], or in hospitalized children who had undergone ocular surgery [33]. Among studies performed in the healthy population, the role of BP was erratically recognized.…”