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Abstract #48400 Published in IGR 13-4
Extent of asymmetry and unilaterality among juvenile onset primary open angle glaucoma patients
Gupta V; Gupta S; Dhawan M; Sharma A; Kapoor KS; Sihota RClinical and Experimental Ophthalmology 2011;
BACKGROUND: Juvenile onset open angle glaucoma due to its rarity is not well characterized. We aimed to assess the extent of inter ocular asymmetry of baseline IOP, disc morphometry and visual field defects at presentation in patients with juvenile onset primary open angle glaucoma (JOAG). DESIGN: Retrospective, single centre, hospital based study. PARTICIPANTS: 52 consecutive JOAG patients who presented with glaucomatous optic neuropathy in at least one eye, without any secondary causes of glaucoma. METHODS: Participants were evaluated for baseline clinical features. The optic disc parameters were measured using scanning laser ophthalmoscopy( HRT). Reliable and reproducible visual field tests using standard 30-2 Humphrey automated perimetry were analysed. MAIN OUTCOME MEASURES: Interocular asymmetry of baseline IOP, vertical cup disc ratio and mean deviation. RESULTS: Fourteen patients (27%) had glaucomatous optic neuropathy in only one eye at initial presentation; the fellow eyes of which had IOP <21mmHg in 8 while 6 had IOP >21mmHg. In twenty out of 52 patients (39%) one eye remained perimetrically unaffected. Patients presenting with bilateral optic neuropathy were found to be significantly younger (24.4 ± 10.6 years) in age compared to those with unilateral optic neuropathy (32 ± 8.2 years). (p = 0.02). CONCLUSIONS: One fourth of juvenile onset primary open angle glaucoma patients present as a unilateral optic neuropathy with 60% of these having normal IOP in the fellow eyes. Primary JOAG may present with considerable asymmetry with a small proportion presenting as a unilateral disease. 14. Clin Experiment Ophthalmol. 2011 Feb 18. doi: 10.1111/j.1442-9071.2011.02534.x. [Epub ahead of print]
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Classification:
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)