TOPLINE:

A retrospective analysis of children diagnosed with glaucoma before the age of 3 years showed visual acuity and intraocular pressure measured 5 years after diagnosis, as well as the presence of nystagmus or angle closure, were significant predictors of long-term outcomes.

METHODOLOGY:

• Researchers conducted a retrospective study to identify risk factors for poor visual acuity and high intraocular pressure in children with glaucoma.
• They analyzed 396 eyes of 243 patients (51% boys) who were younger than 3 years at the initial visit and had at least 5 years of follow-up; the mean age at presentation was 1.5 months.
• For each patient, sex, race, ethnicity, age of onset of glaucoma, laterality, and other details were recorded; for each eye, the presence of significant anisometropia or isometropia, opacity of the ocular media, nystagmus, dysgenesis of the anterior segment, strabismus, and angle closure was recorded.
• Data were collected at the initial visit, at 3 and 5 years, and at the final visit; the mean duration between initial and final visits was 9.5 years.

TAKEAWAY:

• High intraocular pressure at 5 years; poor visual acuity at all prior visits; and having opacity of the ocular media, nystagmus, or dysgenesis of the anterior segment were associated with a worsening of visual acuity at the final visit.
• Having glaucoma in both eyes at any visit and high intraocular pressure and poor visual acuity at 3 and 5 years were associated with an increase in intraocular pressure at the final visit.
• In a multivariate analysis, visual acuity at 5 years and angle closure emerged as significant predictors of visual acuity at the final visit (P = .011 and P < .001, respectively), and intraocular pressure at 5 years and nystagmus were identified as significant predictors of intraocular pressure at the final visit (P = .013 and P = .041, respectively).

IN PRACTICE:

"Certain factors observed early in the diagnosis and management of childhood glaucoma may predict poor outcomes," the researchers reported. "Creating a severity classification for childhood glaucoma will enable the implementation of standardized treatment guidelines, promoting more consistent and efficient care for children with glaucoma. This system could greatly improve clinical decision-making and enhance the ability to predict long-term outcomes in affected children,” they added.

SOURCE:

The study was led by Huda Sheheitli, MD, of the Department of Ophthalmology and Visual Neurosciences at the University of Minnesota in Minneapolis. It was published online on September 22 in the Journal of Glaucoma.

LIMITATIONS: 

The study was limited by a relatively small sample size and substantial missing data across demographic variables. The analysis did not account for where patients lived or whether their insurance was private or public. Measurements of visual acuity in nonverbal children were less precise compared to recognition acuity tests.

DISCLOSURES:

The study was supported by the National Institutes of Health's National Center for Advancing Translational Sciences. The authors reported no relevant financial conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.