The profile of childhood glaucoma — results of a 20-year retrospective study

Abstract

In 2013, at the 9th Congress of the World Glaucoma Association, a new classification of childhood glaucoma was adopted.PURPOSE. This study analyzes the profile of childhood glaucoma in accordance with the new classification and evaluates the convenience of its use in clinical and research work.METHODS. We reviewed the retrospective data of 652 patients (1000 eyes) aged 0 to 18 years with childhood glaucoma who were under observation between 2002 and 2022. The mean follow-up period was 10.4±0.2 years.RESULTS. The majority of patients had bilateral glaucoma (53.4%). The most common are bilateral manifestations in primary congenital glaucoma (79.7%), juvenile glaucoma (95.8%), secondary glaucoma associated with nonacquired ocular anomalies (54%). The majority of patients in the study were male (363 patients; 56.7%). The most common diagnoses were secondary glaucoma associated with acquired conditions (42.6%), primary congenital glaucoma was diagnosed in 21% of cases. In the vast majority of cases (from 52% to 85%), the treatment of glaucoma was surgical. The maximum number of repeated hypotensive interventions (2.1 operations per eye) was required for patients with primary congenital glaucoma. The results of surgical treatment of secondary childhood glaucoma turned out to be more optimistic — one operation was enough to control glaucoma in 64.6% (62 eyes out of 96) of operated eyes with glaucoma associated with non-acquired ocular anomalies, in 70.7% of cases (29 eyes out of 41) in glaucoma associated with non-acquired systemic conditions, 66.8% in secondary glaucoma associated with acquired conditions (227 eyes out of 340), and in 68.4% of cases in glaucoma following cataract surgery (39 eyes out of 57). In the course of the observation period, 1239 glaucoma interventions were performed. The intervention of choice in all subgroups was filtering surgery. Cyclodestructive procedures were performed significantly more often (p<0.05) in the group with secondary glaucoma associated with acquired conditions. CONCLUSION. The use of a unified classification system is expected to greatly enhance the understanding of this disease, and consequently improve childhood glaucoma management approaches and standards of clinical care in rare types of this disease.>p<0.05) in the group with secondary glaucoma associated with acquired conditions.CONCLUSION. The use of a unified classification system is expected to greatly enhance the understanding of this disease, and consequently improve childhood glaucoma management approaches and standards of clinical care in rare types of this disease.