Rééducation de la part fonctionnelle de l’amblyopie dans le glaucome primitif infantile opéré, recul de 11 ans

Abstract

To evaluate the efficacy of functional amblyopia treatment in children having undergone surgery for primary infantile glaucoma. Parameters studied included: age at surgery, current age, visual acuity (VA) (initial and most recent acuity), refraction, alignment, adherence to amblyopia treatment, condition of the cornea (Haab striae, stromal scarring, pachymetry, cell count), condition of the optic disc (cupping, RNFL OCT) and intraocular pressure. Pearson's p-value was fixed at 5%. Retrospective study of 29 eyes; average age at surgery was four months, mean follow-up was 11.2 years. Initial VA averaged 4.5 over 10, most recent VA 7 over 10, i.e. a gain of 2.3 over 10. Refraction revealed 37.9% myopia, 10.3% emmetropia, 48.2% hyperopia and an average astigmatism of 2.14 D. A negative correlation was found between astigmatism and most recent VA (rho=-0.7; P<0.001). A positive correlation was found between the quality of the occlusion therapy and the recovery of VA with a gain of 3.2 over 10 (P=0.001). A strong positive correlation was found between the cylinder power and the number of Haab striae [rho0.702, P<0.0001]; final VA is best when the striae show no organized scar formation (P=0.04). This study underlines the necessity of prolonged treatment of functional amblyopia in primary infantile glaucoma for the best possible visual rehabilitation.