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Am J OphthalmolJanuary 20216 citations

Risk Factors for Blindness in Children With Primary Congenital Glaucoma-Follow-up of a Registry Cohort.

Alshigari Rayan, Freidi Alia, Souru Ches, Edward Deepak P, Malik Rizwan


AI Summary

This study found severe corneal clouding at presentation predicts future blindness in children with primary congenital glaucoma, highlighting the need for aggressive management and counseling for these high-risk patients.

Abstract

Purpose

To evaluate the baseline features associated with blindness in a cohort of children with primary congenital glaucoma (PCG) from a hospital registry.

Design

Retrospective clinical cohort study.

Methods

Setting: Observational cohort study. StudyPopulation: The registry included all children who presented to our tertiary care institute between 1995 and 2014 with a diagnosis of childhood glaucoma. ObservationProcedure: Baseline characteristics at initial presentation of children with PCG in the registry who were blind at the last follow-up were compared with those who were not blind, using bivariate and then multivariate regressions to account for potential confounders. MainOutcomeMeasures: Blindness was defined as a best-corrected visual acuity of 3/60 (20/400) or worse in the better eye at the final follow-up.

Results

The eligible sample consisted of 196 children with a mean age of 9.54 ± 22.44 months at presentation. After a mean ± standard deviation follow-up of 8.49 ± 3.85 years, 20 (10.2%) children were blind. The baseline demographic factors, intraocular pressure, horizontal corneal diameter, spherical equivalent, axial length, and corneal thickness, were similar for the "blind" and "not blind" groups (P > .05). In the multivariate regression, only the severity of corneal opacification remained significantly (P < .001) associated with the risk of blindness (odds ratio = 4.05; 95% confidence interval: 1.89-8.85).

Conclusion

Corneal clouding is a predictor of future blindness in children with PCG. Children with severe corneal clouding may need more aggressive intraocular pressure control, closer follow-up, and earlier counseling.


MeSH Terms

BlindnessChild, PreschoolCohort StudiesFemaleFollow-Up StudiesHumansHydrophthalmosInfantInfant, NewbornIntraocular PressureMaleRefraction, OcularRegistriesRetrospective StudiesRisk FactorsTonometry, OcularVisual Acuity

Key Concepts4

In a multivariate regression analysis of a retrospective clinical cohort study of 196 children with primary congenital glaucoma, the severity of corneal opacification was significantly associated with the risk of blindness (P < .001) with an odds ratio of 4.05 (95% confidence interval: 1.89-8.85).

PrognosisCohortRetrospective Clinical Cohort Studyn=196 children with PCGCh7

Corneal clouding is identified as a predictor of future blindness in children with primary congenital glaucoma based on a retrospective clinical cohort study of 196 children.

PrognosisCohortRetrospective Clinical Cohort Studyn=196 children with PCGCh7

In a retrospective clinical cohort study of 196 children with primary congenital glaucoma (PCG) from a hospital registry, 20 (10.2%) children were blind after a mean follow-up of 8.49 ± 3.85 years. Blindness was defined as a best-corrected visual acuity of 3/60 (20/400) or worse in the better eye at the final follow-up.

PrognosisCohortRetrospective Clinical Cohort Studyn=196 children with PCGCh7

In a retrospective clinical cohort study of 196 children with primary congenital glaucoma, baseline demographic factors, intraocular pressure, horizontal corneal diameter, spherical equivalent, axial length, and corneal thickness were similar for the "blind" and "not blind" groups (P > .05).

PrognosisCohortRetrospective Clinical Cohort Studyn=196 children with PCG

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