1
|
Glandorf K, Rothaus K, Baquet-Walscheid K, Heinz C, Heiligenhaus A. Surgical Glaucoma Treatment in Patients with Juvenile Idiopathic Arthritis-Associated Uveitis: Results after Trabeculectomy or Ahmed Glaucoma Valve Implantation. Ocul Immunol Inflamm 2024; 32:636-641. [PMID: 36898006 DOI: 10.1080/09273948.2023.2185263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE Patients with juvenile idiopathic arthritis (JIA) associated uveitis (JIAU) are at risk for secondary glaucoma, frequently requiring surgical management. We compared the success rates for trabeculectomy (TE) and Ahmed glaucoma valve (AGV) implantation. METHODS We conducted a retrospective analysis of TE (45 eyes), primary AGV (pAGV) (7 eyes), or secondary AGV (sAGV) implantation after TE (11 eyes) in JIAU at the 2-year follow-up. RESULTS All groups achieved significant pressure reduction. After 1 year, the overall success rate was higher in the Ahmed groups (p = 0.03). After adjusting the p-value according to Benjamin Hochberg, there is no significant difference between the groups in the Kaplan-Meier, despite a significant logrank test between all groups (p = 0.0194) and a better performance in the Ahmed groups. CONCLUSION Slightly better success rates were achieved with pAGV in managing JIAU patients with glaucoma refractory to medical treatment.
Collapse
Affiliation(s)
- Karen Glandorf
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - Kai Rothaus
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
| | - Karoline Baquet-Walscheid
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
- Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
| | - Carsten Heinz
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
- Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
| | - Arnd Heiligenhaus
- Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany
- Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
2
|
Sarohia GS, Elsayed MEAA, Solarte CE, Hornby SJ, Brookes J, Chang TCP, Malik R. Outcome measures in childhood glaucoma: a systematic review of randomized controlled trials. Graefes Arch Clin Exp Ophthalmol 2023; 261:2625-2639. [PMID: 37119307 DOI: 10.1007/s00417-023-06061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/01/2023] Open
Abstract
PURPOSE To synthesize the outcome measures used by randomized controlled trials (RCTs) for childhood glaucoma. METHODS MEDLINE, EMBASE, and Scopus were searched from inception to February 17, 2023. Randomized controlled trials and observational studies related to childhood glaucoma were included. Primary and secondary outcomes were extracted and the data was used to generate a literature review. RESULTS This review identified 42 unique reports pertaining to childhood glaucomas. Most of the studies originated from Egypt, India, and the USA. Intraocular pressure (IOP) outcomes were the most frequent outcomes studied, followed by clinical outcomes and safety outcomes. Clinical outcomes were the most common secondary outcomes studied, followed by IOP outcomes and safety outcomes. CONCLUSIONS This systematic review found heterogenous outcomes with IOP outcomes as the most studied primary outcome. As the remaining outcomes were not consistently utilized, this review highlights the need for a consensus on studies of pediatric glaucoma.
Collapse
Affiliation(s)
- Gurkaran S Sarohia
- Department of Ophthalmology and Visual Sciences, University of Alberta, 400, 10924, 107 Avenue, Edmonton, AB, T5H 0X5, Canada
| | | | - Carlos Eduardo Solarte
- Department of Ophthalmology and Visual Sciences, University of Alberta, 400, 10924, 107 Avenue, Edmonton, AB, T5H 0X5, Canada.
| | - Stella J Hornby
- Oxford Eye Hospital, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - John Brookes
- Glaucoma Department, Moorfields Eye Hospital, London, UK
| | | | - Rizwan Malik
- Department of Surgery, Sheikh Khalifa Medical City, Abu Dhabi, UAE
| |
Collapse
|
3
|
Shen R, Li VSW, Wong MOM, Chan PPM. Pediatric Glaucoma-From Screening, Early Detection to Management. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020181. [PMID: 36832310 PMCID: PMC9954748 DOI: 10.3390/children10020181] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Pediatric glaucoma (PG) covers a rare and heterogeneous group of diseases with variable causes and presentations. Delayed diagnosis of PG could lead to blindness, bringing emotional and psychological burdens to patients' caregivers. Recent genetic studies identified novel causative genes, which may provide new insight into the etiology of PG. More effective screening strategies could be beneficial for timely diagnosis and treatment. New findings on clinical characteristics and the latest examination instruments have provided additional evidence for diagnosing PG. In addition to IOP-lowering therapy, managing concomitant amblyopia and other associated ocular pathologies is essential to achieve a better visual outcome. Surgical treatment is usually required although medication is often used before surgery. These include angle surgeries, filtering surgeries, minimally invasive glaucoma surgeries, cyclophotocoagulation, and deep sclerectomy. Several advanced surgical therapies have been developed to increase success rates and decrease postoperative complications. Here, we review the classification and diagnosis, etiology, screening, clinical characteristics, examinations, and management of PG.
Collapse
Affiliation(s)
- Ruyue Shen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Venice S. W. Li
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | - Mandy O. M. Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | - Poemen P. M. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, China
- Correspondence: ; Tel.: +852-3943-5807
| |
Collapse
|
4
|
Lingham G, Thakur S, Safi S, Gordon I, Evans JR, Keel S. A systematic review of clinical practice guidelines for childhood glaucoma. BMJ Open Ophthalmol 2022; 7:e000933. [PMID: 35136841 PMCID: PMC8804684 DOI: 10.1136/bmjophth-2021-000933] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/18/2022] [Indexed: 12/19/2022] Open
Abstract
ObjectiveTo conduct a systematic review to identify and critically appraise clinical practice guidelines on the assessment, diagnosis and management of childhood glaucoma.Methods and analysisA systematic literature search of databases and professional websites for clinical practice guidelines published on eye conditions between 2010 and April 2020 in English was conducted. Identified guidelines were screened for relevance to childhood glaucoma and exclusion criteria applied. Guidelines that passed the screening and quality appraisal with the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool and, if they achieved a mean score of ≥45 and ≥3 on subsets of 9 and 5 AGREE II items, respectively, were selected for inclusion and data extracted using a standardised form.ResultsFollowing screening and critical appraisal, three guidelines were included for data extraction. None of the three guidelines was specifically developed for childhood glaucoma. A consistent recommendation was that children should undergo some form of eye screening examination or a comprehensive eye assessment to detect paediatric eye disease. Children at high risk of childhood glaucoma should undergo additional screening. One clinical practice guideline recommended interventions for childhood glaucoma consisting of tube surgery and topical beta-blockers or carbonic anhydrase inhibitors. Recommended interventions for childhood glaucoma were based on low-quality to moderate-quality evidence or expert opinion.ConclusionBased on our selection criteria, we did not identify any high-quality clinical practice guidelines specifically targeted at childhood glaucoma. This is compounded by the lack of high-quality evidence on childhood glaucoma.
Collapse
Affiliation(s)
- Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
| | | | - Sare Safi
- Ophthalmic Research Centre, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- World Health Organization Collaborating Centre for the Eye Care and Prevention of Blindness, Tehran, Iran
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stuart Keel
- Vision and Blindness Prevention Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
5
|
Kaushik S, Gupta G, Thattaruthody F, Dhingra D, Kumari K, Arora A, Snehi S, Raj S, Pandav SS. Goniotomy for initial and re-surgery for childhood glaucoma in Northern India. Indian J Ophthalmol 2021; 69:2088-2094. [PMID: 34304184 PMCID: PMC8482893 DOI: 10.4103/ijo.ijo_3305_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The aim of this study was to describe the effectiveness of goniotomy for childhood glaucoma in Indian eyes. Methods Consecutive patients with pediatric glaucoma who underwent goniotomy between July 2017 and June 2020, in a single center in Northwest India were prospectively analyzed. Goniotomy was done as a primary procedure or a re-do surgery of the untreated angle in failed filtering surgery. Success was defined as intraocular pressure (IOP) ≦18 mm Hg with or without 2 topical medications. Results A total of 172 eyes of 126 children underwent goniotomy during this period (37.9% of all pediatric glaucoma surgeries). Goniotomy comprised 132 of 211 (62.5%) primary pediatric glaucoma surgeries and 40 of 243 (16.5%) re-do surgeries. 145, 112, and 54 eyes had a six months, 1-year and 2-year follow-up, respectively. At 1 year, success rates in Primary Congenital Glaucoma (PCG) were 79.7% for primary surgery and 68.4% for re-do surgery. For non-PCG eyes, the success rate was 62% at 1 year. Among PCG subgroups, infantile and newborn glaucoma had 87.5% and 57.1% success rates, respectively. On logistic regression analysis, lower baseline IOP and lesser axial length at presentation were significantly predictive of successful outcomes (P = 0.03 and P = 0.02, respectively). At 1 year, in the primary surgery group, 50% had good vision (better than logMAR 0.5), 28.9% had moderate (better than LOGMAR 1.0) and 20% had severe visual impairment. There were no significant intraoperative or post-operative complications. Conclusion Goniotomy appears to be an effective surgery for childhood glaucoma in Indian eyes. Being minimally invasive, it obviates the need for conjunctival and scleral dissection and antifibrotic agents.
Collapse
Affiliation(s)
- Sushmita Kaushik
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gaurav Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Faisal Thattaruthody
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepika Dhingra
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kiran Kumari
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Arora
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sagarika Snehi
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Srishti Raj
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder S Pandav
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
6
|
Ozdemir O, Arman A, Tayman C. Intraocular pressure effect of anti-vascular endothelial growth factor injection for aggressive posterior retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol 2021; 259:3469-3476. [PMID: 34151383 DOI: 10.1007/s00417-021-05278-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To compare the effect of 0.0125 mL and 0.025 mL doses of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on intraocular pressure (IOP) in eyes with aggressive posterior retinopathy of prematurity (ROP). METHODS In this retrospective cohort study, charts of 52 eyes of 26 consecutive infants were reviewed. The patients received 0.0125 mL (Group 1) or 0.025 mL (Group 2) anti-VEGF agents' intravitreally. The IOP was measured before injection, on the first day, during the first week, and in the first month. After each injection, optic nerve head perfusion was evaluated by a binocular indirect ophthalmoscope. IOP values, complications, use of antiglaucomatous drops, and the effects of anti-VEGF drugs were recorded. RESULTS The mean baseline IOP before injection was 16.0 ± 3.7 mmHg for Group 1 and 15.5 ± 4.5 mmHg for Group 2 (p = 0.365). The mean value of IOP on the first day was statistically increased in Group 2 (29.2 ± 6.1 mmHg) compared with Group 1 (24.1 ± 6.8 mmHg) (p = 0.013). Moreover, antiglaucomatous drops were needed in 12 eyes for Group 2 compared with seven eyes for Group 1. Anterior chamber paracentesis was not performed after any of the injections. CONCLUSION This study found that IOP increases after intravitreal injections of anti-VEGF agents for the treatment of ROP. The injection of 0.025 mL anti-VEGF agents increases IOP more than the 0.0125 mL injection in the treatment of infants with aggressive posterior ROP.
Collapse
Affiliation(s)
- Ozdemir Ozdemir
- Department of Ophthalmology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Aysegul Arman
- Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
7
|
Abstract
Aims and objectives This study aimed at describing the characteristics and outcomes of pediatric glaucoma patients in a university hospital in Lebanon and comparing them between primary congenital glaucoma (PCG) and secondary glaucoma. Materials and methods Sixty-four eyes of 40 pediatric glaucoma patients with a follow-up of 1 year or more were reviewed. Parameters were studied for both PCG and secondary glaucoma groups. Three major outcomes were considered: intraocular pressure (IOP) control, final best-corrected visual acuity (BCVA), and the proportion of failed angle surgeries. Results Sixty-four eyes were included divided into 29 PCG and 35 secondary glaucoma eyes, followed up for a mean of 6.6 ± 4.7 years. Eyes with PCG presented earlier, with a higher initial IOP and underwent earlier surgery than their secondary glaucoma counterparts. Although 85.9% of all eyes achieved good IOP control, 44.4% of them had a BCVA ≥20/50 with PCG having a better visual prognosis. Secondary glaucoma eyes needed more medications at the end of their follow-up. In this group, it was shown that a later age at first surgery, unilateral disease, and multiple surgeries were associated with a BCVA < 20/50. Conclusion Patients with PCG presented earlier and with a higher IOP than secondary glaucoma; they were also operated on earlier. Both groups demonstrated good IOP control at the end of the follow-up period with PCG eyes having a superior visual outcome. Secondary glaucoma eyes required a higher number of medications at their final visit. In this population, multiple surgeries, unilateral disease, and a delayed first surgery conferred a poorer visual prognosis. Clinical significance Data regarding the characteristics of pediatric glaucoma, especially in the Middle East, are scarce. Our study sheds the light on the presentation of different types of pediatric glaucoma and their outcomes namely IOP control and visual acuity. How to cite this article Dakroub M, Khair D, Noureddine B, et al. Pediatric Glaucoma in a University Hospital. J Curr Glaucoma Pract 2021;15(1):8-13.
Collapse
Affiliation(s)
- Mohamad Dakroub
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Governorate, Lebanon
| | - Diana Khair
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Governorate, Lebanon
| | - Bahaa' Noureddine
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Governorate, Lebanon
| | - Christiane Al-Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Governorate, Lebanon
| |
Collapse
|
8
|
Response to "Letter to the Editor relating to Graefe's Arch Clin Exp Ophthalmol. 2020 June. 'Medical management of pediatric glaucoma: lessons learned from randomized clinical trials'". Graefes Arch Clin Exp Ophthalmol 2020; 259:2049-2050. [PMID: 32734469 DOI: 10.1007/s00417-020-04857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022] Open
|
9
|
Quaranta L, Riva I, Micheletti E, Katsanos A. Letter to the Editor relating to Graefe's Arch Clin Exp Ophthalmol. 2020 June. "Medical management of pediatric glaucoma: lessons learned from randomized clinical trials". Graefes Arch Clin Exp Ophthalmol 2020; 259:2047-2048. [PMID: 32696322 DOI: 10.1007/s00417-020-04856-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 06/20/2020] [Accepted: 07/15/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Luciano Quaranta
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia IRCCS Fondazione Policlinico San Matteo, Piazzale Golgi, 2, 27100, Pavia, Italy.
| | | | - Eleonora Micheletti
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia IRCCS Fondazione Policlinico San Matteo, Piazzale Golgi, 2, 27100, Pavia, Italy
| | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| |
Collapse
|