Greenberg Matthew B, Osigian Carla J, Cavuoto Kara M, Chang Ta C
University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Bascom Palmer Eye Institute, Miami, Florida, United States of America.
PLoS One. 2017 Sep 25;12(9):e0185546. doi: 10.1371/journal.pone.0185546. eCollection 2017.
To investigate the outcomes of childhood glaucoma suspects.
Retrospective case series.
Records of childhood glaucoma suspects were identified using financial claims data; medical history, baseline biometric and exam findings were recorded. Conversion from suspect to glaucoma was determined based on the Childhood Glaucoma Research Network criteria. The study adheres to the tenets of the Declarations of Helsinki.
214 subjects were enrolled, with median age at initial presentation of 6.37 years (interquartertile range: Q1 = 2.46, Q3 = 8.90). 22 (10.2%) subjects developed glaucoma, 64 (29.9%) had ocular hypertension but no glaucoma, 9 (4.2%) had high-risk condition or syndrome without either ocular hypertension or glaucoma after a mean follow up of 39 +/- 34 months. Neither a family history of glaucoma nor patient gender was significantly different between the groups. 40.2% of subjects (86 of 214) had two or more episodes of intraocular pressure (IOP) > 21 mmHg, among which 25.6% (22 of 86) developed glaucoma after a mean duration of 32.8 +/- 33.5 months.
Up to 25% of children with 2 or more episodes of elevated IOP may develop glaucoma. In 50% of suspects who converted to glaucoma, elevated IOP was not present at the initial evaluation. There is no significant difference in gender, family history, or baseline central corneal thickness between suspects who developed glaucoma compared to the rest. While suspects who converted to glaucoma had higher average, maximum and minimum IOP measurements, there is no clear cutoff between the groups.
研究儿童青光眼疑似患者的转归情况。
回顾性病例系列研究。
利用财务索赔数据识别儿童青光眼疑似患者的记录；记录病史、基线生物特征和检查结果。根据儿童青光眼研究网络标准确定从疑似患者转变为青光眼的情况。本研究遵循《赫尔辛基宣言》的原则。
共纳入214名受试者，初次就诊时的中位年龄为6.37岁（四分位数间距：Q1 = 2.46，Q3 = 8.90）。平均随访39±34个月后，22名（10.2%）受试者发展为青光眼，64名（29.9%）患有高眼压症但未患青光眼，9名（4.2%）患有高危疾病或综合征，既无高眼压症也无青光眼。各组之间青光眼家族史和患者性别均无显著差异。40.2%的受试者（214名中的86名）有两次或更多次眼压（IOP）>21 mmHg发作，其中25.6%（86名中的22名）在平均32.8±33.5个月的病程后发展为青光眼。
眼压升高2次或更多次的儿童中，高达25%可能发展为青光眼。在转变为青光眼的疑似患者中，50%在初次评估时眼压并未升高。与其余疑似患者相比，发展为青光眼的疑似患者在性别、家族史或基线中央角膜厚度方面无显著差异。虽然转变为青光眼的疑似患者的平均、最大和最小眼压测量值较高，但两组之间没有明确的临界值。
