Long-term functional and structural outcomes in patients with primary congenital glaucoma—A Danish nationwide study

IF 3 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2023-10-05 DOI:10.1111/aos.15772

Troels Brynskov, Daniella Bach-Holm, Per Kappelgaard, Volkert Siersma, Karen Bjerg Pedersen, Line Kessel

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Abstract

Purpose

Evaluation of long-term functional and structural outcomes in patients with primary congenital glaucoma (PCG) based on visual acuity (VA), visual field (VF) using standard automated perimetry, and peripapillary retinal nerve fibre layer thickness (pRNFL).

Methods

We retrospectively reviewed medical records of all patients diagnosed with PCG in Denmark from 1977 to 2016. Severe vision loss was defined as VA <6/60 and/or VF >20 decibels (dB). Prognostic factors were evaluated in a correlation matrix.

Results

The median age of the 94 patients (153 PCG eyes) was 12 years (IQR 9–16). In PCG eyes 62% had VA ≥6/18 but 22% had <6/60. VA in the better seeing eye was ≥6/18 in 90% and <6/60 in 5%. VF was measured in 59 PCG eyes and the median mean defect was 5.1 dB (IQR 2.1–9.6) with 52% better than 6 dB and 9% worse than 20 dB. Generalized pRNFL was reduced below the age-expected 1st percentile in 29% of the 58 PCG eyes where pRNFL was measured. Poor VA, poor VF and reduced pRNFL were all correlated (p = 0.0001). More surgeries (p < 0.0001) and longer diagnostic delay (p = 0.004) were associated with poorer vision and to a lesser degree with poor VF pRNFL.

Conclusion

In Denmark, most patients with bilateral PCG retain VA ≥6/18 in the better seeing eye. Poor VA was associated with poor VF. Longer diagnostic delay and more surgeries were associated with a poorer prognosis.

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原发性先天性青光眼患者的长期功能和结构结果——丹麦全国性研究。

目的：根据视力（VA）、使用标准自动视野计的视野（VF）和乳头周围视网膜神经纤维层厚度（pRNFL）评估原发性先天性青光眼（PCG）患者的长期功能和结构结果。方法：我们回顾性回顾了1977年至2016年丹麦所有诊断为PCG的患者的医疗记录。严重视力损失定义为VA 20分贝（dB）。在相关矩阵中评估预后因素。结果：94名患者（153眼PCG）的中位年龄为12岁年（IQR 9-16）。在PCG眼中，62%的患者VA≥6/18，但22%的患者VA≤6/18。结论：在丹麦，大多数双侧PCG患者在视力较好的眼中VA仍≥6/18。VA差与VF差相关。诊断延迟时间越长，手术次数越多，预后越差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.