Long-term functional and structural outcomes in patients with primary congenital glaucoma — A Danish nationwide study
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Long-term functional and structural outcomes in patients with primary congenital glaucoma — A Danish nationwide study. / Brynskov, Troels; Bach-Holm, Daniella; Kappelgaard, Per; Siersma, Volkert; Pedersen, Karen Bjerg; Kessel, Line.
In: Acta Ophthalmologica, Vol. 102, No. 2, 2024, p. 228-237.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term functional and structural outcomes in patients with primary congenital glaucoma — A Danish nationwide study
AU - Brynskov, Troels
AU - Bach-Holm, Daniella
AU - Kappelgaard, Per
AU - Siersma, Volkert
AU - Pedersen, Karen Bjerg
AU - Kessel, Line
N1 - Publisher Copyright: © 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - long-term outcomes
KW - optical coherence tomography
KW - primary congenital glaucoma
KW - primary paediatric glaucoma
KW - retinal nerve fibre layer thickness
KW - standard automated perimetry
U2 - 10.1111/aos.15772
DO - 10.1111/aos.15772
M3 - Journal article
C2 - 37795859
AN - SCOPUS:85173472904
VL - 102
SP - 228
EP - 237
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
SN - 1755-375X
IS - 2
ER -
ID: 370662795