Received 8 March 2005; accepted 14 October 2005. published online 09 January 2006.
Purpose
To investigate the risk factors that influence outcome of visual function in children with glaucoma.
Design
Retrospective noncomparative interventional case series.
Participants
One hundred twenty-six patients (204 eyes) who had childhood glaucoma observed over 30 years, with a mean follow-up of 11.6 years.
Interventions
Full ophthalmologic examination, including measurement of corrected visual acuity (VA), slit-lamp and fundus examinations, intraocular pressure (IOP) measurement, and gonioscopic evaluation; periodic cycloplegic refraction and perimetry; and treatment of amblyopia.
Main Outcome Measures
Type of glaucoma; final best-corrected VA of good (6/6–6/12), fair (6/15–6/30), or poor (≤6/60); patient age at time of development of glaucoma complications; and percentage of IOP measurements of ≤19 mmHg, perimetry results, and cup-to-disc (C/D) ratio during follow-up.
Results
The most recently measured VAs of children treated for glaucoma were good in 29%, fair in 24%, and poor in 47%. The most favorable outcome was for patients with primary infantile glaucoma followed by secondary glaucoma. Amblyopia and optic nerve damage due to glaucoma were the most frequent complications affecting VA. Patients with an IOP of ≤19 mmHg on 80% of determinations had stable optic nerve C/D ratios and visual fields.
Conclusions
Vision sufficient to qualify for a motor vehicle driving license was attainable in almost 30% of affected eyes. Visual acuity achieved at 6 years of age remained stable over the study period. Treatment of amblyopia is important to achieve this result.
1Department of Ophthalmology, University of Karaelmas School of Medicine, Zonguldak, Turkey
3Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Correspondence and reprint requests to Sebnem Hanioglu Kargi, MD, Karaelmas Universitesi Tip Fakultesi, Uygulama ve Arastirma Hastanesi, Goz Hastaliklari AD (Department of Ophthalmology), Kozlu Zonguldak, Turkey.
Manuscript no. 2005-202.
External financial support: none.
Neither the authors nor their families have a proprietary interest in any material used in the study.
ABSTRACT