1
|
Yoo L, Kadambi N, Bohnsack BL. Corneal characteristics and OCT-angiography findings in pediatric glaucoma and glaucoma suspects. J AAPOS 2023; 27:327.e1-327.e6. [PMID: 37913864 DOI: 10.1016/j.jaapos.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE To analyze corneal biomechanics, specular microscopy, and optical coherence tomography-angiography findings in children with glaucoma. METHODS Pediatric patients (<18 years of age) with glaucoma (n = 38), increased cup:disk ratio and normal intraocular pressure (IOP) glaucoma suspects (n = 36), and controls (n = 67) were prospectively enrolled. Patients underwent testing with Ocular Response Analyzer, CellChek Specular Microscope, and Heidelberg OCT-A. RESULTS Average age of participants was 12.4 ± 3.5 years, with no difference between groups (P = 0.71). Glaucoma patients had undergone more intraocular surgeries (P < 0.0001) and showed worse logMAR visual acuity (P < 0.0001) than suspects or controls. Central corneal thickness (CCT) was greater in glaucoma patients (642.8 ± 85.9 μm [P < 0.0001]) and suspects (588 ± 43.7 μm [P = 0.003]) compared with controls (561 ± 39.9 μm). Corneal hysteresis (CH) was decreased in eyes with glaucoma (10.4 ± 3.0) compared with controls (11.7 ± 1.5 [P = 0.006]), but not suspects (11.3 ± 2.0 [P = 0.1]). Glaucoma patients had lower endothelial cell density (2028.4 ± 862.7 [P < 0.0001]) and greater average cell area (547.2 ± 332.4 [P < 0.0005]) compared with suspects (2919.3 ± 319.1, 347.5 ± 46.2) and controls (2913.7 ± 399.2, 350.8 ± 57.7), but there was no difference in polymegathism (P = 0.12) or pleomorphism (P = 0.85). No differences in vessel density or vessel skeletal density in the retinal vascular complex (P = 0.3077, P = 0.6471) or choroidal vascular complex (P = 0.3816, P = 0.7306) were detected. CONCLUSIONS Children with glaucoma showed thicker corneas with lower endothelial cell density and greater cell area, but no difference in retinal/choroidal vascular densities compared with suspects and controls.
Collapse
Affiliation(s)
- Lauren Yoo
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Namrata Kadambi
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brenda L Bohnsack
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois.
| |
Collapse
|
2
|
Wood KS, Ye E, Trivedi RH, Wilson ME. Preoperative central corneal thickness in eyes with pediatric cataract versus normal fellow eyes. J AAPOS 2023; 27:87.e1-87.e4. [PMID: 36871929 DOI: 10.1016/j.jaapos.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To compare the preoperative central corneal thickness (CCT) in eyes with unilateral cataract with their normal fellow eyes in the pediatric population. METHODS A retrospective chart review was conducted using the STORM Kids cataract database. Eyes with traumatic cataract, previous surgery or therapeutic manipulation, or age >18 years were excluded. Only eyes with a normal fellow eye were included. The intraocular pressure, age at time of surgery, race, sex, and type of cataract were also extracted from the record. RESULTS A total of 70 eyes with unilateral cataract and 70 fellow normal eyes met inclusion criteria. The mean age at the time of surgery was 3.35 years (range, 0.08-15.05). The mean preoperative CCT in the operated eyes was 577 ± 58 μm (range, 464-898 μm). The mean preoperative CCT in fellow eyes was 570 ± 35 μm (range, 485-643 μm). There was no statistically significant difference between the preoperative CCT in cataract eyes versus unaffected fellow eyes (P = 0.183). When stratified by age, the difference in the CCT between cataract and fellow eyes was greatest in the <1 year age group, but was not statistically significant (P = 0.236). The mean preoperative corneal diameter of operative eyes was 11.0 mm (range, 5.5-12.5 mm [n = 68]). The mean preoperative IOP was 15.1 mm Hg (n = 66). CONCLUSIONS In our study cohort, there was no significant difference in mean preoperative CCT between unilateral pediatric cataract eyes and unaffected fellow eyes.
Collapse
Affiliation(s)
- Katherine S Wood
- Medical University of South Carolina, Charleston, South Carolina
| | - Emily Ye
- Medical University of South Carolina, Charleston, South Carolina
| | - Rupal H Trivedi
- Medical University of South Carolina, Charleston, South Carolina
| | - M Edward Wilson
- Medical University of South Carolina, Charleston, South Carolina.
| |
Collapse
|
3
|
Brandt JD. Letter to the editor regarding: Congenital aniridia - a comprehensive review of clinical features and therapeutic approaches. Surv Ophthalmol 2021; 67:628. [PMID: 34752787 DOI: 10.1016/j.survophthal.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022]
|
4
|
Landsend ECS, Lagali N, Utheim TP. Authors' response to letter to the editor: Congenital aniridia - a comprehensive review of clinical features and therapeutic approach. Surv Ophthalmol 2021; 67:629-630. [PMID: 34748793 DOI: 10.1016/j.survophthal.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/01/2021] [Indexed: 02/07/2023]
Affiliation(s)
| | - Neil Lagali
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
5
|
Measurement and Analysis of Central Corneal Thickness at Different Postnatal Stages in Chinese Premature Infants. J Ophthalmol 2020; 2020:7313909. [PMID: 33014441 PMCID: PMC7519199 DOI: 10.1155/2020/7313909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose The objective of this study was to evaluate central corneal thickness (CCT) in Chinese premature infants at different postnatal stages to study the peak point and analyze influential factors on CCT development. Methods This was a cross-sectional study of premature infants. Initial CCT measurement was taken at 34 weeks of gestational age (GA) and at intervals until 88 weeks of postmenstrual age (PMA) was reached. The comparison and correlation analysis were carried out to access the association of CCT with gender, birth weight (BW), GA, and retinopathy of prematurity (ROP) for each PMA. The premature infants were divided into the thick CCT group and the thin CCT group according to the average CCT at 40 w. And the difference in CCT between the two groups at subsequent 52 w and 64 w was compared. Results A total of 1726 premature infants (3463 measurements) with an average of 2.21 ± 1.57 measurements were included in this study. The CCT decreased from 34 w GA to 52 w PMA (R = 92.36, P < 0.0001) and then reached a plateau (R = 2.541, P=0.3567). Male (P < 0.05), low BW (P < 0.05), and low GA (P < 0.05) were associated with thicker CCT at the early stage of PMA. The premature infants who had thick CCT at 40 w would have thick CCT at 52 w and 64 w accordingly. Conclusions The CCT values of premature infants decreased over time and plateaued at 52 w PMA. Gender, BW, and GA were considered as the influential factors of CCT at the early stage of PMA. Moreover, CCT at 40 w could forecast its development trend at 52 w or 64 w after birth.
Collapse
|
6
|
Fayed MA, Chen TC. Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia. Surv Ophthalmol 2019; 64:810-825. [DOI: 10.1016/j.survophthal.2019.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
|
7
|
|
8
|
Moschos MM, Nitoda E, Fenzel I, Song X, Langenbucher A, Kaesmann B, Seitz B, Gatzioufas Z. Prognostic factors of pediatric glaucoma: a retrospective study. Int Ophthalmol 2018; 39:359-373. [PMID: 29349523 DOI: 10.1007/s10792-018-0819-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/04/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To correlate the features of certain types of infantile glaucoma with the progression and the prognosis of the disease, highlighting probable risk factors. METHODS Seventy-six patients with pediatric glaucoma were recruited in this retrospective study. All patients underwent ophthalmological examination in the Department of Ophthalmology of the Saarland University Medical Center from January 2001 to December 2012. Our pediatric patients were classified into four different categories of glaucoma: (1) primary congenital glaucoma (presenting buphthalmus), (2) aniridia-related glaucoma, (3) Peters/Rieger's anomaly-related glaucoma and (4) congenital cataract-related glaucoma. Personal data comprised age, sex, nationality, systemic diseases and gestational age. The best-corrected visual acuity (BCVA), the cup-disk ratio (CDR), the intraocular pressure (IOP), the corneal diameter and thickness, along with the Haab striae and corneal haze, were recorded. RESULTS The majority of the children were male (58%) and suffered from aniridia-related glaucoma (38%). Children with aniridia exhibited the worst BCVA. The CDR and IOP were significantly higher in children with primary congenital glaucoma, compared to the other groups, at the first visit. Those children also were with the largest corneal diameter and prevalence of Haab striae compared to the rest groups, whereas corneal haze was found more often and was more pronounced in children with Peters/Rieger's syndrome. CONCLUSIONS We concluded that glaucoma was earlier detected in children with primary congenital glaucoma, who exhibited increased corneal diameter and high percentage of Haab striae comparing to the other groups. However, these children responded successfully to any therapeutic intervention, exhibiting better BCVA and IOP values than the rest groups at the second visit.
Collapse
Affiliation(s)
- Marilita M Moschos
- First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, 6, Ikaria Street, Ekali, 14578, Athens, Greece.
| | - Eirini Nitoda
- First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, 6, Ikaria Street, Ekali, 14578, Athens, Greece
| | - Isabelle Fenzel
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Xuefei Song
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany.,Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai, China
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Barbara Kaesmann
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Zisis Gatzioufas
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany.,Moorfields Eye Hospital, London, UK
| |
Collapse
|
9
|
Clinical management outcomes of childhood glaucoma suspects. PLoS One 2017; 12:e0185546. [PMID: 28945815 PMCID: PMC5612727 DOI: 10.1371/journal.pone.0185546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/14/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the outcomes of childhood glaucoma suspects. Design Retrospective case series. Methods Records of childhood glaucoma suspects were identified using financial claims data; medical history, baseline biometric and exam findings were recorded. Conversion from suspect to glaucoma was determined based on the Childhood Glaucoma Research Network criteria. The study adheres to the tenets of the Declarations of Helsinki. Results 214 subjects were enrolled, with median age at initial presentation of 6.37 years (interquartertile range: Q1 = 2.46, Q3 = 8.90). 22 (10.2%) subjects developed glaucoma, 64 (29.9%) had ocular hypertension but no glaucoma, 9 (4.2%) had high-risk condition or syndrome without either ocular hypertension or glaucoma after a mean follow up of 39 +/- 34 months. Neither a family history of glaucoma nor patient gender was significantly different between the groups. 40.2% of subjects (86 of 214) had two or more episodes of intraocular pressure (IOP) > 21 mmHg, among which 25.6% (22 of 86) developed glaucoma after a mean duration of 32.8 +/- 33.5 months. Conclusions Up to 25% of children with 2 or more episodes of elevated IOP may develop glaucoma. In 50% of suspects who converted to glaucoma, elevated IOP was not present at the initial evaluation. There is no significant difference in gender, family history, or baseline central corneal thickness between suspects who developed glaucoma compared to the rest. While suspects who converted to glaucoma had higher average, maximum and minimum IOP measurements, there is no clear cutoff between the groups.
Collapse
|
10
|
Evaluation of corneal endothelium in adolescents with juvenile glaucoma. J Ophthalmol 2015; 2015:895428. [PMID: 25642345 PMCID: PMC4302359 DOI: 10.1155/2015/895428] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 12/21/2014] [Indexed: 01/12/2023] Open
Abstract
Purpose. To evaluate the endothelial cell density (ECD) and central corneal thickness (CCT) in adolescents with juvenile open-angle glaucoma (JOAG) and ocular hypertension (OH) and to investigate the influence of topical antiglaucoma medications on ECD and CCT in adolescents with JOAG. Methods. ECD and CCT were investigated in 66 eyes of 33 adolescents with JOAG. Depending on the topical treatment the eyes were classified into 4 groups: (1) topical carbonic anhydrase inhibitor, (2) prostaglandin analogs, (3) beta-blocker, and (4) CAI-beta-blocker combination. ECD and CCT were also checked in 24 adolescents with OH and in control group (33 persons). Results. ECD was significantly lower in eyes with JOAG (2639.5 cells/mm2) compared with ECD in eyes with OH (2924.5 cells/mm2) and in control group (2955.5 cells/mm2). CCT was 0.554 mm in eyes with JOAG, 0.55 mm in eyes with OH, and 0.544 mm in control group. ECD in patients with JOAG was 2730 cells/mm2 (1 group), 2773.5 cells/mm2 (2 group), 2539.5 cells/mm2 (3 group), and 2551 cells/mm2 (4 group). CCT was 0.556 mm in 1 group, 0.558 mm in 2 group, 0.532 mm in 3 group, and 0.544 mm in 4 group. Conclusions. Our findings indicate that JOAG and OH did not affect CCT, but JOAG has influence on ECD in adolescents. There were no significant differences between ECD and CCT of eyes treated with different kinds of antiglaucoma medications.
Collapse
|
11
|
Weise KK, Kaminski B, Melia M, Repka MX, Bradfield YS, Davitt BV, Johnson DA, Kraker RT, Manny RE, Matta NS, Schloff S. Intraobserver reliability of contact pachymetry in children. J AAPOS 2013; 17:144-8. [PMID: 23622447 PMCID: PMC3639436 DOI: 10.1016/j.jaapos.2012.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 11/02/2012] [Accepted: 11/06/2012] [Indexed: 12/27/2022]
Abstract
BACKGROUND Central corneal thickness (CCT) is an important measurement in the treatment and management of pediatric glaucoma and potentially of refractive error, but data regarding reliability of CCT measurement in children are limited. The purpose of this study was to evaluate the reliability of CCT measurement with the use of handheld contact pachymetry in children. METHODS We conducted a multicenter intraobserver test-retest reliability study of more than 3,400 healthy eyes in children aged from newborn to 17 years by using a handheld contact pachymeter (Pachmate DGH55; DGH Technology Inc, Exton, PA) in 2 clinical settings--with the use of topical anesthesia in the office and with the patient under general anesthesia in a surgical facility. RESULTS The overall standard error of measurement, including only measurements with standard deviation ≤5 μm, was 8 μm; the corresponding coefficient of repeatability, or limits within which 95% of test-retest differences fell, was ±22.3 μm. However, standard error of measurement increased as CCT increased, from 6.8 μm for CCT less than 525 μm, to 12.9 μm for CCT 625 μm and greater. The standard error of measurement including measurements with standard deviation >5 μm was 10.5 μm. Age, sex, race/ethnicity group, and examination setting did not influence the magnitude of test-retest differences. CONCLUSIONS CCT measurement reliability in children via the Pachmate DGH55 handheld contact pachymeter is similar to that reported for adults. Because thicker CCT measurements are less reliable than thinner measurements, a second measure may be helpful when the first exceeds 575 μm. Reliability is also improved by disregarding measurements with instrument-reported standard deviations >5 μm.
Collapse
Affiliation(s)
- Katherine K Weise
- University of Alabama at Birmingham School of Optometry, Birmingham, Alabama, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Alsaadi MM, Osuagwu UL, Almubrad TM. Effects of inhaled fluticasone on intraocular pressure and central corneal thickness in asthmatic children without a family history of glaucoma. Middle East Afr J Ophthalmol 2013; 19:314-9. [PMID: 22837626 PMCID: PMC3401802 DOI: 10.4103/0974-9233.97936] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: The aim of this study is to report the effects of fluticasone-inhaled corticosteroid on intraocular pressure (IOP) and central corneal thickness (CCT) of asthmatic children without a family history of glaucoma. Materials and Methods: In this prospective study, 93 children were divided into two groups: 69 asthmatic children with no family history of glaucoma who were taking inhaled fluticasone propionate 250 μg daily for at least 6 months (Group 1) and 24 age-matched control subjects without asthma (Group 2). Three measurements each, of IOP and CCT, were performed with a hand-held noncontact tonometer and a noncontact specular microscope, respectively, over a 12-week period. The order of IOP and CCT measured were randomized at each visit. Between-group comparison and the relationship between CCT and IOP measurements were investigated. P < 0.05 was statistically significant. Results: The mean age was 8 ± 2.4 years (range, 5–15 years) and 9 ± 2.9 years (range, 5–15 years) for Groups 1 and 2, respectively (P = 0.1337). The mean IOP was 14 ± 3.3 mmHg (range, 10–24 mmHg) and 14 ± 2.9 mmHg (range, 11–22 mmHg) for Groups 1 and 2, respectively (P = 0.3626). The mean CCT was 531 ± 30.1 μm (range, 467–601 μm) and 519 ± 47.0 μm (range, 415589 μm) for Groups 1 and 2, respectively (P = 0.1625). There was a weak but statistically significant correlation between IOP and CCT in Group 1 (Pearson's R = 0.3580, P = 0.0025). Conclusions: Inhaled fluticasone at the regular dose used in this study over a short period (6–24 months) was not associated with a significant effect on CCT and IOP measured with noncontact devices in asthmatic children between 5 and 15 years, without a family history of glaucoma. A weak correlation between IOP and CCT values in asthmatic children did exist.
Collapse
Affiliation(s)
- Muslim M Alsaadi
- Department of Pediatrics, College of Medicine, King Khalid University Hospital, King Saud University
| | | | | |
Collapse
|
13
|
Current world literature. Curr Opin Ophthalmol 2012; 23:330-5. [PMID: 22673820 DOI: 10.1097/icu.0b013e32835584e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|