Risk of Developing Congenital Glaucoma in Premature Infants with Large Cup/Disc Ratio

Abstract

Purpose: To investigate the risk of congenital glaucoma development in premature infants with large cup/disc ratios: a long-term follow-up study.Methods: The medical records of premature infants with cup/disc ratios of at least 0.3 were retrospectively reviewed. Ophthalmic examinations, including measurements of intraocular pressure (IOP) corneal diameter, and dilated fundoscopy, were periodically performed. Changes in the cup/disc ratio from the first examination to the last follow-up were sought, and clinical factors associated with such changes were analyzed. In addition, glaucoma development was investigated.Results: Seventy-four patients were included; they were monitored for up to 33.96 ± 19.86 months (based on corrected age). At first examination, the mean IOP was 17.12 ± 4.01 mmHg and the horizontal corneal diameter 10.34 ± 0.83 mm. The mean cup/disc ratio was 0.54 ± 0.14 at the first visit and increased significantly to 0.57 ± 0.14 at the last follow-up (<i>p</i> < 0.001). A small baseline cup/disc ratio was associated with a greater change in the cup/disc ratio (regression coefficient β = -0.111, <i>p</i> = 0.028). We found no significant association of such change with gestational age, birth weight, IOP, or corneal diameter. We encountered no case of congenital glaucoma.Conclusions: Even if the cup/disc ratio is at least 0.3 in premature infants, the risk of glaucoma does not seem to be high if the IOP is not high. Prospective studies on more patients are needed.