Abstract

PurposeTo investigate the outcomes of childhood glaucoma suspects.DesignRetrospective case series.MethodsRecords of childhood glaucoma suspects were identified using financial claims data; medical history, baseline biometric and exam findings were recorded. Conversion from suspect to glaucoma was determined based on the Childhood Glaucoma Research Network criteria. The study adheres to the tenets of the Declarations of Helsinki.Results214 subjects were enrolled, with median age at initial presentation of 6.37 years (interquartertile range: Q1 = 2.46, Q3 = 8.90). 22 (10.2%) subjects developed glaucoma, 64 (29.9%) had ocular hypertension but no glaucoma, 9 (4.2%) had high-risk condition or syndrome without either ocular hypertension or glaucoma after a mean follow up of 39 +/- 34 months. Neither a family history of glaucoma nor patient gender was significantly different between the groups. 40.2% of subjects (86 of 214) had two or more episodes of intraocular pressure (IOP) > 21 mmHg, among which 25.6% (22 of 86) developed glaucoma after a mean duration of 32.8 +/- 33.5 months.ConclusionsUp to 25% of children with 2 or more episodes of elevated IOP may develop glaucoma. In 50% of suspects who converted to glaucoma, elevated IOP was not present at the initial evaluation. There is no significant difference in gender, family history, or baseline central corneal thickness between suspects who developed glaucoma compared to the rest. While suspects who converted to glaucoma had higher average, maximum and minimum IOP measurements, there is no clear cutoff between the groups.

Highlights

  • Childhood glaucoma is a heterogeneous group of diseases that result in pressure-related damage to the developing ocular structures [1], and accounts for 2–6% of blindness in children world-wide [2]

  • Neither a family history of glaucoma nor patient gender was significantly different between the groups. 40.2% of subjects (86 of 214) had two or more episodes of intraocular pressure (IOP) > 21 mmHg, among which 25.6% (22 of 86) developed glaucoma after a mean duration of 32.8 +/- 33.5 months

  • Up to 25% of children with 2 or more episodes of elevated IOP may develop glaucoma

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Summary

Introduction

Childhood glaucoma is a heterogeneous group of diseases that result in pressure-related damage to the developing ocular structures [1], and accounts for 2–6% of blindness in children world-wide [2]. Childhood glaucoma suspects constitute a significant proportion (approximately 38.5%) of the patients seen in a referral pediatric glaucoma service [3]. The incidence and risk factors of glaucoma conversion in these childhood glaucoma suspects are unknown. In this retrospective study, we investigated the baseline demographic and ocular characteristics as well as the outcomes of childhood glaucoma suspects managed in a tertiary referral center

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