Optic disc morphology in congenital glaucoma.

OBJECTIVES

This cross sectional study aimed to evaluate the optic disc morphology with respect to the optic disc size, tilt and torsion in eyes of children with congenital glaucoma.

METHODS

Children with congenital glaucoma (controlled with therapy), including primary congenital glaucoma (PCG) and those with Axenfeld-Rieger Malformation (ARM) who were now cooperative for fundus photography and scanning laser ophthalmoscopy, were recruited. Controls were age and gender matched children, who were following up at our institute for refractive error or had undergone strabismus surgery before the age of 3 years and were now old enough to cooperate for a fundus photography. Fundus photographs were evaluated using Image J processing software to obtain optic disc tilt and torsion. Axial length (AL) and optic disc area (DA) were correlated with the disc tilt and torsion. The axial length, optic disc area, optic disc tilt, optic disc torsion were compared between affected eyes with PCG with those of healthy controls and the unaffected eyes of unilateral PCG as well as between PCG and those with ARM.

RESULTS

Affected eyes of children with PCG (n = 109) had a DA (2.3 ± 0.7 mmvs. 2.1 ± 0.5 mm), disc tilt (1.1 ± 0.1 vs. 1.1 ± 0.2) and disc torsion (median 10 vs. 6 degree) not significantly different (p = 0.8, p = 1, p = 0.61 respectively) from eyes of healthy children (n = 96). Mean AL in PCG eyes was significantly greater (p < 0.028) than in healthy control eyes and correlated with the DA in PCG eyes (Pearson correlation=0.32, p = 0.014). Affected eyes of children with unilateral congenital glaucoma (n = 33) had a DA (2.3 ± 0.54 mmvs. 2.1 ± 0.54 mm), disc tilt (1.1 ± 0.09 vs. 1.1 ± 0.1) and disc torsion (median 10 vs. 10 degree) not significantly different (p = 0.64, p = 0.1, p = 0.75 respectively) from the unaffected eyes. However, eyes of patients with ARM had higher disc torsion compared to controls (p = 0.043).

CONCLUSION

Despite axial elongation, the optic disc morphology of children with primary congenital glaucoma are not significantly different from healthy controls.