Balekudaru Shantha, Sankaranarayanan Nandhini, Agarkar Sumita
J Pediatr Ophthalmol Strabismus. 2017 Jul 1;54(4):250-255. doi: 10.3928/01913913-20170322-01. Epub 2017 May 17.
To assess the prevalence, incidence, and risk factors for the development of glaucoma in patients with aniridia.
Retrospective analysis of case records of patients diagnosed as having congenital aniridia between January 1986 and December 2011 was performed. Patients with a follow-up of more than 12 months were included.
Ninety-one patients (180 eyes) with the diagnosis of aniridia were identified from the case records. Two eyes were excluded from the final analysis; one had developed phthisis and the other had been enucleated. Seventy-four patients (81.3%) were younger than 18 years at initial presentation. The prevalence of glaucoma at presentation was 28.8%, which could be further categorized as ocular hypertension in 19 eyes (10.5%) and glaucoma in 33 eyes (18.3%). Thirty-one eyes (28.4%) developed elevated intraocular pressure (IOP) during the follow-up period: ocular hypertension in 23 eyes (17.9%) and glaucoma in 8 eyes (6.25%). The mean IOP at the time of diagnosis was 33.9 ± 8.6 mm Hg (range: 24 to 60 mm Hg). The mean duration of follow-up was 8.1 ± 5.7 years (range: 1 to 28 years). The cumulative probability of developing elevated IOP was 4% at the end of 8 years of follow-up; this increased to 88% at the end of 28 years of follow-up. Univariate logistic regression analysis identified higher baseline IOP (odds ratio [OR]: 1.2; 95% confidence interval [CI]: 1.2 to 1.4) and limbal stem cell deficiency (OR: 2.8; 95% CI: 1.4 to 5.6) as significant risk factors for the development of elevated IOP. Higher baseline IOP remained significant on multivariate analysis (OR: 1.2; 95% CI: 1.2 to 1.4).
Glaucoma occurs in a substantial proportion of patients with aniridia. Eyes with increased IOP at baseline are at a higher risk. [J Pediatr Ophthalmol Strabismus. 2017;54(4):250-255.].
评估无虹膜患者青光眼的患病率、发病率及发病风险因素。
对1986年1月至2011年12月期间诊断为先天性无虹膜的患者病历进行回顾性分析。纳入随访时间超过12个月的患者。
从病历中确定了91例（180只眼）诊断为无虹膜的患者。最终分析排除2只眼；1只眼发生眼球痨，另1只眼已被摘除。74例患者（81.3%）初诊时年龄小于18岁。初诊时青光眼的患病率为28.8%，其中19只眼（10.5%）为高眼压症，33只眼（18.3%）为青光眼。31只眼（28.4%）在随访期间眼压升高：23只眼（17.9%）为高眼压症，8只眼（6.25%）为青光眼。诊断时的平均眼压为33.9±8.6 mmHg（范围：24至60 mmHg）。平均随访时间为8.1±5.7年（范围：1至28年）。随访8年末眼压升高的累积概率为4%；随访28年末增至88%。单因素逻辑回归分析确定较高的基线眼压（比值比[OR]：1.2；95%置信区间[CI]：1.2至1.4）和角膜缘干细胞缺乏（OR：2.8；95% CI：1.4至5.6）是眼压升高的重要风险因素。多因素分析中较高的基线眼压仍具有显著性（OR：1.2；95% CI：1.2至1.4）。
相当一部分无虹膜患者会发生青光眼。基线眼压升高的眼风险更高。[《小儿眼科与斜视杂志》。2017；54(4)：250 - 255。]
