Prevalence and Clinical Characteristics of Childhood Glaucoma at a Tertiary Care Children’s Hospital

Abstract

Supplemental Digital Content is available in the text. Precis: Glaucoma suspect was the most prevalent category in this study followed by glaucoma associated with acquired ocular anomaly and juvenile open-angle glaucoma. Primary congenital glaucoma was diagnosed in only 3% of the population studied. Purpose: To describe the prevalence and clinical characteristics of childhood glaucoma diagnosed over a 10-year period among patients aged 18 years or below who were seen at a tertiary care children’s hospital using the new Childhood Glaucoma Research Network classification system. Methods: Medical records of all patients aged 18 years or below (n=108) who were diagnosed with glaucoma between January 1, 2008 through September 30, 2018 were reviewed. Data collected included demographics (age at diagnosis, sex, and family history of glaucoma), intraocular pressure, disc-to-cup ratio, retinal nerve fiber layer thickness, and refractive errors. Clinical characteristics of each patient were evaluated according to the criteria established by Childhood Glaucoma Research Network. Categorical distributional equivalence comparisons were performed using the Pearson χ2 test. A P-value <0.05 was defined as statistically significant. Results: A total of 108 patients with a diagnosis of childhood glaucoma or glaucoma suspect were included in this study. Sixty-four percent of these patients were males (P<0.0001). The mean age at the time of diagnosis was 7.07±5.4 years. “Glaucoma suspect” was the most prevalent category (46%, P=0.0002), followed by glaucoma associated with the acquired ocular anomaly (20%) and juvenile open-angle glaucoma (16%). Primary congenital glaucoma represented 3% and all these patients were males. Sixty-nine percent of the patients had bilateral involvement (P=0.0073). The highest intraocular pressure recorded in the study was 57\u2009mm\u2009Hg, the largest cup-to-disc ratio was 0.96, and the lowest retinal nerve fiber layer measurement was 39\u2009μm. Ninety-two percent of the patients had refractive errors and 85% of them had astigmatism. Conclusions: Establishing a pattern and the associated clinical characteristics of childhood glaucoma at tertiary care children’s hospitals will help in developing collaborative research efforts and effective treatment/management strategies for children with these rare groups of disorders.