scholarly journals The Epidemiological and Clinical Findings from the Latvian Registry of Primary Congenital Glaucoma and Evaluation of Prognostic Factors

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 44
Author(s):  
Eva Elksne ◽  
Kristine Baumane ◽  
Arturs Ozolins ◽  
Sandra Valeina
Keyword(s):  
Prognostic Factors ◽  
Relative Risk ◽  
Diagnostic Delay ◽  
Congenital Glaucoma ◽  
Tertiary Referral Centre ◽  
Primary Congenital Glaucoma ◽  
Male Predominance ◽  
Live Births ◽  
The Mean

Background and objectives: primary congenital glaucoma (PCG) is a rare, potentially blinding disease that affects children worldwide. The aim of the study was to describe the epidemiological and clinical characteristics, outcomes for newly diagnosed patients with PCG, as well as evaluate the prognostic factors that are related to the outcomes. Materials and Methods: a retrospective cohort study was conducted at a tertiary referral centre among patients diagnosed with PCG. Evaluation of the clinical data was performed preoperatively at three, six, and 12 months after the surgery and at the last follow-up. Results: during the 15 years of follow-ups, 24 eyes of 18 patients were diagnosed with PCG. Unilateral and bilateral PCG constituted 50% of cases each. A slight male predominance was observed (55.6% vs. 44.4%), with a relative risk of 1.3. The incidence of PCG was 1:19,033 live births. The mean age of the patients at the time of diagnosis was 10.1 ± 10.0 months, with a diagnostic delay of 2.0 ± 1.9 months. Furthermore, 75% of patients indicated an enlargement of an eyeball, followed by excessive tearing (58.3%) and corneal opacity (41.7%). After 85.9 ± 51.2 months, the mean intraocular pressure (IOP) value was 14.6 ± 4.9 mmHg. Surgical treatment provided sufficient IOP control in 75% of PCG cases at the last follow-up visit. The only prognostic factor that was related to the outcome of IOP control that was statistically significant was axial length at the time of diagnosis. Conclusions: the incidence of PCG in Latvia was 5.3 patients per 100,000 live births. PCG was more common among males than females with a relative risk of 1.3. The enlargement of an eyeball was the leading clinical sign.

scholarly journals Axial Length Changes Following Surgical Intervention in Children With Primary Congenital Glaucoma

2021 ◽  
Vol 1 ◽  
Author(s):  
Hind A. Al Dalgan ◽  
Ibrahim A. Al Obaida ◽  
Adi M. Al Owaifeer ◽  
Khabir Ahmad ◽  
Rizwan Malik
Keyword(s):  
Axial Length ◽  
Substantial Reduction ◽  
Glaucoma Surgery ◽  
Mixed Effects ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Post Surgery ◽  
Length Changes ◽  
The Mean

BackgroundPrimary congenital glaucoma (PCG) is a challenging condition to diagnose, treat and effectively monitor. Serial assessment of intraocular pressure (IOP), optic disc cupping, refraction, and axial length (AxL) after surgery are useful to assess disease control. This study aimed to evaluate AxL changes in relation to IOP changes following glaucoma surgery in children with PCG.MethodsWe retrospectively studied AxL changes in children with PCG undergoing surgery. Eyes of children aged ≤ 4 years that did not have prior ocular surgery and that underwent at least one glaucoma surgery during the course of follow-up between June 2014 and July 2018, were included. The effect of change in IOP on change in AxL was estimated using linear mixed effects models.ResultsA total of 105 eyes (of 72 children) with PCG underwent glaucoma surgery representing 26.4% (105/397) eyes. The mean ± SD age of children at baseline was 3.53 ± 4.04 months. At baseline, the mean IOP and AxL were 26.63 ± 9.57 mmHg and 21.67 ± 1.82 mm, respectively. During the course of follow-up post-surgery, the IOP decreased by a mean of 7.25 ± 12.08 mmHg while the AxL increased by a mean of 0.70 ± 1.40 mm. A multivariable mixed effects linear regression revealed that change in AxL was significantly associated with change in IOP (p=0.030) and time since first surgery (p<0.001). A substantial reduction in IOP (≥35 mmHg) was needed at 3 months post-surgery, for AxL to regress.ConclusionIn children with PCG who undergo glaucoma surgery, change in IOP significantly influences change in AxL. For AxL to regress, a substantial reduction in IOP is needed post-surgery.

scholarly journals Microcatheter–Assisted Circumferential Trabeculotomy in Primary Congenital Glaucoma: Long-Term Clinical Outcomes

2022 ◽  
Vol 11 (2) ◽  
pp. 414
Author(s):  
Luigi Fontana ◽  
Alberto Neri
Keyword(s):  
Clinical Outcomes ◽  
Primary Outcome ◽  
Glaucoma Surgery ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Age At Surgery ◽  
The Mean ◽  
One Year

Purpose: The purpose of this study was to report the long-term efficacy and clinical outcomes of microcatheter-assisted circumferential trabeculotomy (MCT) in children with primary congenital glaucoma (PCG). Methods: This is a single-center retrospective study including consecutive children with PCG who underwent MCT with > two years follow up. The primary outcome was surgical success, defined as intraocular pressure (IOP) ≤ 21 mmHg with (qualified) or without (complete) medications, measured at six months, one year, and then annually. Secondary outcomes were visual acuity (VA), refraction, axial length (AXL), complications, reinterventions, and number of medications. Results: Twelve eyes of ten patients were included. In eight children only one eye was affected. The mean ± standard deviation (SD) age at surgery was 6.3 ± 4.1 months. The mean postoperative follow-up was 66 ± 35 months. The mean IOP was 34.3 ± 9.6 mmHg preoperatively and 14.6 ± 2.3 mmHg postoperatively at the last visit (p < 0.001). Complete success was achieved at all time points in 10 out of 12 eyes, while 2 eyes had a qualified success. At three years of age, the mean VA of the operated eyes was 0.25 ± 0.12 logMAR, the mean spherical equivalent was −0.78 ± 1.43 diopters, and the mean AXL was 23.78 mm. Transient hyphema was the only complication observed. None of the children required additional glaucoma surgery. Conclusions: Circumferential trabeculotomy for PCG effectively lowers the IOP at more than two years after surgery. Following this procedure, the prognosis for the visual function is good, and the refractive error is low. Postoperative complications were not significant.

scholarly journals Combined trabeculotomy-trabeculectomy with antimetabolite and releasable suture: outcome with primary congenital glaucoma in a north Indian population

2015 ◽  
Vol 7 (1) ◽  
pp. 16-25 ◽  
Author(s):  
S Dubey ◽  
A Agrawal ◽  
L Chauhan ◽  
S Mukherjee ◽  
G Douglas
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Indian Population ◽  
Case Series ◽  
Congenital Glaucoma ◽  
North Indian Population ◽  
Success Rates ◽  
Primary Congenital Glaucoma ◽  
The Mean

Objective: To determine the surgical outcomes of combined trabeculotomy- trabeculectomy with mitomycin-C and releasable suture in children with primary congenital glaucoma (PCG) in a North Indian population. Design: Retrospective, interventional, consecutive, non-comparative case series. Materials and methods: The medical records of 137 eyes of 77 patients who underwent combined trabeculotomy- trabeculectomy with 0.2 mg/ml mitomycin C (MMC) either bilaterally (49 patients) or unilaterally (28 patients) between January 2004 and March 2012 were reviewed retrospectively. The main outcome measures were postoperative intraocular pressures, corneal clarity and diameter, duration of follow-up, success rate and complications. Results: The mean preoperative intraocular pressure reduced from 34 ± 7 mm Hg (range 15- 54 mm Hg) to 17 ± 7 mm Hg (range 5 - 32 mm Hg) with a mean reduction of 44 % (P < 0.001). The mean follow-up period was 24.4 ± 10.3 months (range 6 – 48 months). Complete success defined as intraocular pressure < 21 mm Hg without any medication and clinically stable glaucoma at last follow-up was achieved in 113 eyes (83 %) while a ‘quali¿ed success’ of intraocular pressure < 21 mm Hg with one medication was achieved in ten eyes (7 %). The Kaplan-Meier survival analysis revealed success rates (at ‘n’ months) of 90 % (6), 85 % (12), 82 % (24), 80 % (36) and 77 % (48). There were no signi¿cant intraoperative or postoperative complications.Conclusion: Primary combined trabeculotomy-trabeculectomy with mitomycin-C and releasable suture offers a viable surgical option in Northern Indian infants with primary congenital glaucoma. The use of 0.2 mg/ml mitomycin C for 2 minutes improves the overall success while the releasable suture decreases the risk of postoperative complications especially associated with the use of antimetabolites.

Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

2021 ◽  
pp. 112067212110104
Author(s):  
Mehmet Talay Koylu ◽  
Fatih Mehmet Mutlu ◽  
Alper Can Yilmaz
Keyword(s):  
Intraocular Pressure ◽  
Female Patient ◽  
Congenital Glaucoma ◽  
Safe Procedure ◽  
Primary Congenital Glaucoma ◽  
History Of ◽  
Kahook Dual Blade ◽  
The Right ◽  
Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

scholarly journals Incidence and Characteristics of Retinoblastoma in Poland: The First Nationwide Study 2010–2017

2021 ◽  
Vol 18 (12) ◽  
pp. 6539
Author(s):  
Michał S. Nowak ◽  
Bożena Romanowska-Dixon ◽  
Iwona Grabska-Liberek ◽  
Michał Żurek
Keyword(s):  
Western Europe ◽  
External Beam Radiotherapy ◽  
Cohort Analysis ◽  
Developed Countries ◽  
Live Births ◽  
Focal Treatment ◽  
Different Types ◽  
The Mean ◽  
Birth Cohort Analysis

Background: The present study aimed to investigate the incidence and characteristics of retinoblastoma in the overall population of Poland. Methods: The retrospective survey of both National Health Fund (NHF) and National Cancer Registry (NCR) databases were performed to identify all retinoblastoma cases in Poland in the years 2010–2017. Results: During 2010–2017, the mean age-standardised incidence of retinoblastoma (the unit of incidence is per 1,000,000 person-years) was 10.15 (95% CI 7.23–13.08) among children aged 0 to 4 years and 5.39 (95% CI 4.18–6.60) in those aged 0 to 9 years. During 2010–2014 (to allow 5 years of follow-up), the mean incidence of retinoblastoma by birth cohort analysis in Poland was 4.89 (95% CI 4.04–5.74) per 100,000 live births, corresponding to an incidence of 1 per 20,561 (95% CI 15,855–25,267) live births. In Poland, 14.6% of children with retinoblastoma had enucleation of the eye globe, 76.8% received different types of chemotherapy combined with focal treatment, 5.9% were treated with external beam radiotherapy, and 2.7% were treated with focal treatments only. Conclusions: The incidence of retinoblastoma and the pattern of medical management of retinoblastoma in Poland was similar to that reported in developed countries in Western Europe, Asia, and North America.

Cataract extraction in patients with primary congenital glaucoma

2019 ◽  
Vol 30 (3) ◽  
pp. 525-532
Author(s):  
Laura Morales-Fernández ◽  
José María Martínez-de-la-Casa ◽  
Blanca Benito-Pascual ◽  
Federico Saénz-Francés ◽  
Enrique Santos-Bueso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Extraction ◽  
Hazard Ratio ◽  
High Rate ◽  
Congenital Glaucoma ◽  
Primary Congenital Glaucoma ◽  
Corneal Decompensation

Objective: To assess incidence and risk factors of cataract extraction in patients with primary congenital glaucoma, surgical outcome, and complications. Material and method: Retrospective cohort study, in which 108 patients with primary congenital glaucoma were included. Data collected were need for cataract extraction and at what age, intraocular pressure at diagnosis of primary congenital glaucoma, required antiglaucomatous surgeries, possible mutation in the CYP1B1 gene, and final visual acuity. Among the patients who required cataract extraction were visual acuity, intraocular pressure, and complications, evaluated preoperatively and postoperatively. The data were analysed with STATA. Results: A total of 198 eyes of 108 patients were included, with a median follow-up of 8 years (range: 5–53). In all, 32 eyes (16.2%) of 24 patients (22%) required cataract extraction. The median age for cataract extraction was 12.94 years (interquartile range: 2.42–22). The main identified risk factors associated with cataract extraction were antiglaucomatous surgeries (hazard ratio 1.48, p < 0.001) and valvular implant (hazard ratio 2.78, p < 0.001). Lens was implanted in 30/32 eyes and the main complications were intraocular pressure decontrol ( n = 13), capsular fibrosis ( n = 7), corneal decompensation ( n = 4), lens subluxation ( n = 4), and endophthalmitis ( n = 1). Visual acuity improvement was observed after cataract extraction in 66.67% of eyes. Conclusions: There is a high incidence of cataract surgery in patients with primary congenital glaucoma, but generally outside of pediatric age. A greater risk of cataract extraction was identified in those patients with a greater number of antiglaucomatous surgeries, especially after valvular implantation. Despite the high rate of complications related to cataract extraction in primary congenital glaucoma, good visual improvement was observed after surgery.

Long-term functional outcomes of different subtypes of primary congenital glaucoma

2019 ◽  
pp. bjophthalmol-2019-315131 ◽  
Author(s):  
Richard Sher Chaudhary ◽  
Amisha Gupta ◽  
Ajay Sharma ◽  
Shikha Gupta ◽  
Rayees Ahmad Sofi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Congenital Glaucoma ◽  
Cumulative Probability ◽  
Primary Congenital Glaucoma ◽  
Visual Outcomes ◽  
Post Surgery ◽  
Kaplan Meier ◽  
Significant Difference

AimTo analyse long-term visual outcomes across different subtypes of primary congenital glaucoma (PCG).MethodsPatients with PCG with a minimum of 5-year follow-up post surgery were included in the study. Snellen visual acuity recordings taken at their last follow-up were analysed. We evaluated the results using Kaplan-Meier curves to predict the probability of maintaining good vision (as defined by a visual acuity of 6/18 or better) in our patients after 30-year follow-up. The results were also analysed to determine whether there were any differences in the long-term visual acuities with time between the neonatal and infantile PCG. We also analysed the reasons for poor visual outcomes.ResultsWe assessed a cohort of 140 patients with PCG (235 eyes) with an average follow-up of 127±62.8 months (range 60–400 months). Overall, the proportion of eyes with good visual acuity was 89 (37.9%), those with fair visual acuity between 6/60 and 6/18 was 41 (17.4%), and those with poor visual acuity (≤6/60) was 105 (44.7%). We found a significant difference (p=0.047) between neonatal and infantile patients with PCG whereby the neonatal cohort fared worse off in terms of visual morbidity. On Kaplan-Meier analysis, the cumulative probability of survival of a visual acuity of 6/18 or better was more among the infantile PCG in comparison to the neonatal PCG (p=0.039) eyes, and more among the bilateral than the unilateral affected eyes (p=0.029). Amblyopia was the most important cause for poor visual acuity as shown on a Cox proportional-hazards regression model .ConclusionsLong-term visual outcomes of infantile are better than neonatal PCG. Eyes with unilateral have worse visual outcomes compared with those with bilateral PCG because of the development of dense amblyopia.

Micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma

2019 ◽  
Vol 30 (5) ◽  
pp. 1149-1155 ◽  
Author(s):  
Eman M Elhefney ◽  
Tharwat H Mokbel ◽  
Sherein M Hagras ◽  
Ahmed A AlNagdy ◽  
Adel A Ellayeh ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Diode Laser ◽  
Congenital Glaucoma ◽  
Secondary Outcome ◽  
Cumulative Probability ◽  
Pediatric Glaucoma ◽  
Significant Difference ◽  
The Mean ◽  
Diode Laser Cyclophotocoagulation

Purpose: To evaluate the intermediate-term efficacy and safety of micropulsed diode laser cyclophotocoagulation in recurrent pediatric glaucoma. Patients and Methods: A prospective interventional study included children <16 years old diagnosed with recurrent glaucoma, attending Mansoura University, during the period from July 2017 to November 2017. Micropulsed diode laser sessions were performed in all the cases. The main outcome was the intraocular pressure reduction with monitoring of complications as secondary outcome. The mean follow-up period was 15.08 ± 1.1 (mean: 12–16) months. Results: A total of 36 eyes of 29 patients were included (62% males) with median age of 24 months. Primary congenital glaucoma represented 47.2% of the initial diagnoses. At the 15th month, the mean intraocular pressure dropped significantly from 37.5 ± 11.3 mmHg at baseline to 20.03 ± 2.7 mmHg (p < 0.001) with 37.15% reduction. The mean number of glaucoma medications decreased significantly from 2.6 ± 0.5 pretreatment to 1.7 ± 0.6 at the 15th month (p < 0.001). A total of 24 eyes (66.7%) required second session of treatment with mean number of 1.7 ± 0.5 sessions per eye. The cumulative probability of qualified success was 69.4%, 58.3%, 52.8%, 47.2%, and 41.7% at 1, 3, 6, 12, and 15 months after treatment. Qualified success was achieved in 61% at 15 months without statistically significant difference between the initial diagnoses (p = 0.61). None of the eyes developed any major ocular complications throughout the follow-up period. Conclusion: Micropulsed diode laser was proved to be a safe approach with relative effectiveness in controlling intraocular pressure in children with recurrent glaucoma.

scholarly journals Anencephaly: Do the Pregnancy and Maternal Characteristics Impact the Pregnancy Outcome?

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Isabela Nelly Machado ◽  
Sílvia Dante Martinez ◽  
Ricardo Barini
Keyword(s):  
Survival Time ◽  
Maternal Age ◽  
Statistical Tests ◽  
Maternal Characteristics ◽  
Live Births ◽  
Parity Number ◽  
History Of ◽  
The Mean ◽  
Elective Termination

Objective. To describe the characteristics of obstetric and perinatal outcome of a group of pregnancies complicated by an anencephalic fetus. Methods. Observational study including anencephalic fetuses, divided into groups according to the evolution of pregnancy: elective termination of pregnancy ETP; stillbirths (SBs); live births (LBs), and loss of follow-up. After a univariate description of the sample, some variables were compared using statistical tests. Results. 180 anencephalic fetuses were included. The mean maternal age was 25.3 years. In 71 fetuses (39%) were found additional anomalies. Comparing the groups, no statistical differences in maternal age (), parity (), number of previous abortion (), fetal sex () and additional anomalies () were found. Among those fetuses whose parents opted for continuation of pregnancy (), 20 spontaneous intrauterine deaths occurred (38%) and 33 were live births (62%). The average postnatal survival time was 51 minutes. There was no association between survival time and gestational age () or the presence of additional malformations (). Conclusion. Results presented here could contribute to a better understanding of the natural history of this malformation, allowing obstetricians a more detailed discussion with the families.

Prognostic Factors Affecting the Clinical Outcome of Septic Arthritis of the Shoulder

2016 ◽  
Vol 21 (03) ◽  
pp. 339-344 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Geon-Myeong Oh
Keyword(s):  
Prognostic Factors ◽  
Los Angeles ◽  
Clinical Outcome ◽  
Septic Arthritis ◽  
Clinical Outcomes ◽  
Open Surgery ◽  
Positive Culture ◽  
Factors Affecting ◽  
The Mean

Background: The objective of this study was to determine prognostic factors affecting the clinical outcome of septic arthritis of the shoulder. Methods: We retrospectively reviewed 34 shoulders from 32 patients, two of which had bilateral involvement. Arthroscopic (22 shoulders) or open surgery (12 shoulders) was performed by a single surgeon. The mean follow-up period was 32.4 ± 17.0 months. Clinical outcomes according to the University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and Subjective Shoulder Value (SSV) were assessed at the final follow-up period. Various factors were included for statistical analysis. Results: The mean UCLA, ASES scores, and SSV were 28.9 ± 7.2, 81.3 ± 21.0, 79.7 ± 2.5%, respectively. Positive culture was observed in only 13 shoulders (38.2%) and the most common organism was Staphylococcus aureus (seven shoulders). Five shoulders (14.7%) required two or three operations. Age and comorbidity were negatively correlated with the UCLA, ASES score, and/or SSV (p < 0.05). There was no correlation between clinical outcome and various parameters, including gender, location of lesion, history of previous steroid injection, interval between onset of symptoms and surgical intervention, bacterial organisms, operative method, and presence of rotator cuff tear and reoperation (p > 0.05). Conclusions: Both arthroscopic and open surgery for septic shoulders showed satisfactory clinical outcomes. Old age and comorbidity were poor prognostic factors of clinical outcomes after treatment.

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