Long-Term Follow-Up Results and Visual Outcomes of Childhood Glaucoma in the Black Sea Region of Turkey

Abstract

Purpose To investigate long-term visual outcomes and factors associated with low vision in patients with childhood glaucoma. Materials and methods A retrospective review was conducted on the medical records of pediatric glaucoma patients at the Ondokuz May & imath;s University Ophthalmology Clinic from 2005 to 2023. The patients were categorized into three groups: primary congenital glaucoma (PCG), secondary childhood glaucoma, and glaucoma following cataract surgery (GFCS). Groups were analyzed regarding visual acuity (VA), ocular conditions and comorbidities, and the cause of visual impairment. The study also investigated the potential risk factors associated with visual impairment. Results A total of 105 eyes of 60 patients with a mean age of 9.7 +/- 5.5 years were included in the study. The mean VA in logMAR was 0.59 +/- 0.52. At the final follow-up, 34.1% had good VA (>= 20/50), 29.5% had moderate VA (20/50-20/200), and 36.4% had poor VA (< 20/200). The final mean intraocular pressure (IOP) was 16.2 +/- 6.2 mmHg. Amblyopia was the leading cause of vision loss (38.2%), followed by glaucomatous damage (36.4%). Patients with GFCS had a higher rate of visual impairment (42.4%) and refractive error. The results of the regression analysis showed that low vision was associated with undergoing more than two surgeries, high IOP at baseline, high initial and final cup-to-disc (C/D) ratio, and high initial central corneal thickness (CCT) (CI 95%, p = 0.018, p= 0.017, p = 0.013, p = 0.003, p = 0.001, respectively). Conclusion Good VA can be achieved in 34.1% of childhood glaucoma cases. However, the VA prognosis may be worse in patients with GFCS. Achieving good visual outcomes in childhood glaucoma requires timely and effective treatment, consideration of risk factors, and management of amblyopia and ocular comorbidities.