Paediatric glaucoma in Hong Kong: a multicentre retrospective analysis of epidemiology, presentation, clinical interventions, and outcomes

Baig, Nafees; Chan, Joyce; Ho, Jeffrey; Tang, Geoffrey C. H.; Tsang, Susanna; Wan, Kelvin H; Yip, Wilson W K; Tham, Clement C.

doi:10.12809/hkmj208833

Cited by 11 publications

(13 citation statements)

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“…Elevated IOP was observed in 32.97% of the patients and was the most common reason for referral and visiting our center. In Hong Kong, only 12.2% of pediatric glaucomatous eyes were identified by high IOP (2). The relatively concentrated medical resources in provincial capital cities in mainland China could be the reason for this.…”

Section: Discussionmentioning

confidence: 99%

“…Congenital glaucoma is an important risk factor for visual impairment in children (1). Hence, the burden of pediatric glaucoma may substantially diminish the quality of life in affected individuals (2).…”

Section: Introductionmentioning

confidence: 99%

“…The primary goal of glaucoma treatment is intraocular pressure (IOP) reduction, for which medical treatment is often the first-line treatment. For long-term treatment, surgery may be the definitive option for IOP reduction especially in cases of pediatric glaucoma (2). Various types of new glaucoma surgeries have emerged in recent years and may benefit pediatric glaucoma patients (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Analysis of Pediatric Glaucoma in Central China

Liu

et al. 2022

Front. Med.

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PurposeWe aimed to describe the characteristics, epidemiology, management, and outcomes of glaucoma in pediatric patients in central China.MethodsThis study retrospectively analyzed inpatients with pediatric glaucoma at Henan Provincial People's Hospital, Henan Eye Institute, and Henan Eye Hospital between 2017 and 2020.ResultsOverall, 239 cases (276 eyes) of pediatric glaucoma in patients, comprising 87 girls (36.40%) and 152 boys (63.60%) were analyzed. The mean age was 6.65 ± 4.46, and 2.93% of the patients had a family history of glaucoma. Primary congenital glaucoma (PCG) was the most common type of glaucoma, followed by traumatic glaucoma in 8.33% of the patients, which was considered secondary glaucoma. The most common signs and symptoms were elevated intraocular pressure (IOP) and eye pain. Trabeculotomy (Trab) and microcatheter-assisted 360° trabeculotomy (MAT) combined with Trab were the most commonly performed surgeries. The IOP of patients with PCG, juvenile open-angle glaucoma (JOAG), and secondary glaucoma were 15.27 ± 7.48 mmHg, 17.16 ± 10.05, and 18.65 ± 8.55, respectively, at the final follow up. The rate of re-operations in patients with PCG, JOAG, and secondary glaucoma were 9.15%, 6.78%, and 4.69%, respectively. The mean visual acuity of the eyes with PCG, JOAG, and secondary glaucoma was 0.79 ± 0.68, 0.51 ± 0.48, and 0.53 ± 0.50, respectively.ConclusionPCG, JOAG, and traumatic glaucoma were the most prevalent subtypes in patients with pediatric glaucoma in central China. Trab and MAT combined with Trab were the most common interventions used in this study. Pediatric amblyopia might require full attention during the entire treatment, especially after glaucoma surgery. Effective preventive measures and more public education on glaucoma prevention and the importance of early diagnosis and treatment is necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Analysis of Pediatric Glaucoma in Central China

Liu

et al. 2022

Front. Med.

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“…[21,22] The background prevalence of the disease types in the dataset was similar to that reported in epidemiological studies. [2,20,23] The most common type of glaucoma was primary congenital glaucoma (31%), followed by anterior segment dysgenesis (22%), retinopathy of prematurity (14%) and Sturge-Weber syndrome (14%). In contrast, our dataset has several characteristics.…”

Section: Discussionmentioning

confidence: 99%

Deep-Learning Approach to Detect Childhood glaucoma Based on Periocular Photograph

Kitaguchi

Hayakawa

Kawashima

et al. 2022

Preprint

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Childhood glaucoma is one of the major causes of blindness in children, however, its diagnosis is of great challenge. The study aimed to demonstrate and evaluate the performance of a deep-learning (DL) model for detecting childhood glaucoma based on periocular photographs. Primary gaze photographs of children diagnosed with glaucoma with appearance features (corneal opacity, corneal enlargement, and/or globe enlargement) were retrospectively collected from the database of a single referral center. DL framework with the RepVGG architecture was used to automatically recognize childhood glaucoma from photographs. The average receiver operating characteristic curve (AUC) of 5-fold cross-validation was 0.91. When the 5-fold result was assembled, the DL model achieved an AUC of 0.95 with a sensitivity of 0.85 and specificity of 0.94. The DL model showed comparable accuracy to the pediatric ophthalmologists and glaucoma specialists in diagnosing childhood glaucoma (0.90 vs 0.81, p = 0.22, chi-square test), outperforming the average of human examiners in the detection rate of childhood glaucoma in cases without corneal opacity (72% vs. 34%, p = 0.038, chi-square test), with a bilateral corneal enlargement (100% vs. 67%, p = 0.03), and without skin lesions (87% vs. 64%, p = 0.02). Hence, this DL model is a promising tool for diagnosing missed childhood glaucoma cases.

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“…Recent retrospective studies conducted by Baig et al , Bouhenni et al , Saavedra et al , and Chan et al have reviewed the epidemiology of JOAG in pediatric populations [3 ▪ ,4,5 ▪ ,6]. Only patients 18 years of age or less were included, and average age at diagnosis was 12 and 10 years [3 ▪ ,5 ▪ ]. JOAG has a slightly higher prevalence among males compared with females, and a majority of patients have bilateral involvement [3 ▪ ,4,5 ▪ ,6].…”

Section: Epidemiology and Clinical Presentationmentioning

confidence: 99%

Juvenile open angle glaucoma: current diagnosis and management

Ciociola¹,

Klifto

2021

Current Opinion in Ophthalmology

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Purpose of reviewThe aim of this article is to summarize up-to-date research on the diagnosis and management of juvenile open-angle glaucoma (JOAG). Recent findingsJOAG can be subclassified into four clinical phenotypes, and faster myopic shift is a risk factor for disease progression. Vessel density is associated with structural damage and worsening visual acuity in JOAG and can be monitored with optical coherence tomography angiography. Genetic studies have revealed molecular causes of JOAG including variants in CPAMD8, MYOC, and CYP1B1. Tube shunt surgeries as well as gonioscopy-assisted transluminal trabeculotomy have been shown to be successful in JOAG. SummaryAlthough genetic advances may improve future screening, intraocular pressure monitoring and fundoscopic exam remain the current mainstay of diagnosis. Medical treatment alone for JOAG is typically insufficient with patients requiring surgical management. Selective laser trabeculoplasty may delay or decrease the need for surgery. Trabeculectomy has traditionally been shown to be effective in JOAG, but tube shunt surgery and microinvasive glaucoma surgery are effective alternatives.

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Paediatric glaucoma in Hong Kong: a multicentre retrospective analysis of epidemiology, presentation, clinical interventions, and outcomes

Cited by 11 publications

References 0 publications

Clinical Analysis of Pediatric Glaucoma in Central China

Clinical Analysis of Pediatric Glaucoma in Central China

Deep-Learning Approach to Detect Childhood glaucoma Based on Periocular Photograph

Juvenile open angle glaucoma: current diagnosis and management

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