Topical versus oral carbonic anhydrase inhibitor therapy for pediatric glaucoma

Portellos, Maria; Buckley, Edward G.; Freedman, Sharon F.

doi:10.1016/s1091-8531(98)90109-4

Cited by 66 publications

(32 citation statements)

References 12 publications

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“…Systemic side effects have to be monitored with greater care in children especially in vulnerable neonates. Beta-blockers (Boger 1983;Hoskins 1985), systemic (deLuise 1983;Portellos 1998) and topical (Portellos 1998) carbonic anhydrase inhibitors have been shown to be effective in PCG although the systemic side effects require monitoring (deLuise 1983;Olson 1979;Passo 1984;Portellos 1998). Prostaglandin analogues (Enyedi 2002) and miotics (Allingham 2005b) may not be as effective in infants with PCG as adults.…”

Section: Cyclodestructive Proceduresmentioning

confidence: 99%

Surgical interventions for primary congenital glaucoma

Ghate¹,

Kedar²

2010

Cochrane Database of Systematic Reviews

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Section: Cyclodestructive Proceduresmentioning

confidence: 99%

Surgical interventions for primary congenital glaucoma

Ghate¹,

Kedar²

2010

Cochrane Database of Systematic Reviews

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“…[3][4][5][6][7] Goniotomy and trabeculotomy were initially considered for congenital glaucoma, with comparable results. [8][9][10][11] Viscotrabeculotomy, using viscoelastic material during trabeculotomy, may increase success rates through prevention of both postoperative haemorrhage and adhesion of the incision lips.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

Yang

Park

2008

Eye

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Purpose To evaluate clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma. Methods A retrospective review was conducted on 34 eyes from 29 patients with refractory glaucoma, who were younger than 18 years of age and who underwent Ahmed valve implantation. The main outcome measures were intraocular pressures (IOPs) and the number of glaucoma medications used. Qualified success was defined as IOP p21 mm Hg regardless of the number of glaucoma medications. Complete success was defined as IOP p21 mm Hg without glaucoma medication.Results Mean age at operation was 5.5 years (range, 0-16). Fifteen eyes (44.1%) had undergone previous glaucoma surgery before Ahmed valve implantation. Mean follow-up time was 29.1 months (range, 3-31). IOP was reduced from a preoperative mean of 37.5 ± 7.3 to 18.4 ± 7.3 mm Hg at 6 months postoperatively (Po0.01). At 12 months after surgery, the success rates were 63.3% (qualified success) and 13.3% (complete success). The cumulative probabilities of qualified success at 6, 12, and 24 months after Ahmed valve implantation were 89.0, 68.6, and 45.7%, respectively. The median time of survival was 19.6 ± 0.9 months. Conclusions Ahmed valve implantation is effective in lowering IOP in refractory paediatric glaucoma, with limited survival after long-term follow-up. Addition of a second Ahmed valve may be effective in the management of failure after primary implantation.

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“…[81][82][83][84][85] Oral carbonic anhydrase inhibitors are not indicated for infants due to possible Central nervous system depression, apnea, and hypotension in the neonate/infant Carbonic anhydrase inhibitors Possible teratogenic, metabolic acidosis in the breastfed child it is not known if they are excreted in the milk Dorzolamide is approved by the American Academy of Pediatrics during lactation with punctal occlusion Prostaglandin analogues Uterine contractions and premature labor Parasympathomimetics Cholinergic effects in the newborn metabolic acidosis, urolithiasis, lethargy, paresthesia, and anorexia; topical formulations are less efficient but safer, especially brinzolamide. [86][87][88][89][90] Brimonidine, an adrenergic agonist, must be avoided in neonates, infants, and young children, in consideration of central nervous system toxicity. [91][92][93][94] In PCG, prostaglandin analogus and prostamides are mainly used as adjunctive medication.…”

Section: Medical Therapymentioning

confidence: 99%

Pediatric glaucoma: current perspectives

Marchini¹,

Toscani²,

Chemello³

2014

PHMT

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"Childhood glaucoma" is a heterogeneous group of severe pediatric conditions often associated with significant visual loss and characterized by elevated intraocular pressure (IOP) and optic-disk cupping. Successful IOP control is crucial but challenging and most often achieved surgically, with medical therapy playing a supportive role. There are many classifications of childhood glaucoma, but they can simply be divided into primary, in which a developmental abnormality of the anterior chamber angle only exists, and secondary, in which aqueous outflow is reduced due to independent mechanisms that secondarily impair the function of the filtration angle. The worldwide prevalence of childhood blindness ranges from 0.03% in high-income countries to 0.12% in undeveloped countries. The majority of cases do not have an identified genetic mutation and, where the mutation is known, the genes often account for only a small proportion of cases. Several pathogenetic mechanisms are known to contribute to the development of childhood glaucoma. Whatever the cause, it results in a reduced aqueous outflow at the level of the trabecular meshwork. Age of onset and magnitude of the elevated IOP largely determine the clinical manifestation the high variability of clinical manifestations. Glaucoma from any cause in a neonate and infant is characterized by the classic triad of epiphora, photophobia, and blepharospasm, and could be associated with eye enlargement (buphthalmos) and Haab striae. The eye examination, usually performed under general anesthesia, includes: tonometry, anterior-segment examination, gonioscopy, corneal diameter and axial length measurement, dilated fundoscopy with optic-nerve-head evaluation. Medical therapy, considering the high frequency of side effects, is generally used as temporizing IOP-lowering treatment before surgery or as adjuvant treatment postoperatively in case of partially successful procedures for refractory glaucomas. Surgery is the nodal point of the management of refractory childhood glaucoma, so it is crucial to opt for a forward-looking strategy to reach the target IOP and minimize the visual loss.

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Topical versus oral carbonic anhydrase inhibitor therapy for pediatric glaucoma

Cited by 66 publications

References 12 publications

Surgical interventions for primary congenital glaucoma

Surgical interventions for primary congenital glaucoma

Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

Pediatric glaucoma: current perspectives

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