Prevalence and Clinical Characteristics of Childhood Glaucoma at A Tertiary Care Children's Hospital.

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 ≤18 years of age who were seen at a tertiary care children's hospital using the new Childhood Glaucoma Research Network (CGRN) classification system.

PATIENTS AND METHODS: Medical records of all patients ≤18 years (n=108) who were diagnosed with glaucoma between 1/1/2008 through 9/30/2018 were reviewed. Data collected included demographics (age at diagnosis, gender, family history of glaucoma), intraocular pressure (IOP), disc-to-cup ratio, retinal nerve fiber layer (RNFL) thickness, and refractive errors. Clinical characteristics of each patient were evaluated according to the criteria established by CGRN. Categorical distributional equivalence comparisons were performed using Pearson chi-square. P<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 (64%) 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 acquired ocular anomaly (20%), and juvenile open-angle glaucoma (16%). Primary congenital glaucoma (PCG) represented 3% and all these patients were male. Sixty nine (69) %, of the patients had bilateral involvement (P=0.0073). The highest IOP recorded in the study was 57▒mm Hg, the largest cup-to-disc ratio was 0.96 and the lowest RNFL measurement was 39▒μ. Ninety-two (92%) of 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.