Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Childhood Glaucoma Research Group, Seoul National University (SNU), Seoul, Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Childhood Glaucoma Research Group, Seoul National University (SNU), Seoul, Korea; Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea.
Am J Ophthalmol. 2020 Dec;220:183-190. doi: 10.1016/j.ajo.2020.08.003. Epub 2020 Aug 12.
To determine if the size and location of facial port-wine stains (PWS) can predict glaucoma risk in neonates.
Retrospective cohort study.
Children with facial PWS who had undergone ophthalmologic examination within 4 weeks of their birth were included. Clinical information, including facial photographs, intraocular pressure, corneal diameter, optic disc cup-to-disc ratio, and Sturge-Weber syndrome (SWS) diagnoses were collected. Based on facial photographs, PWS distribution, eyelid involvement, and PWS scores according to degree of involvement in each embryonic facial vasculature distribution (segment [S]1, S2 and S3) were evaluated.
Among the 34 patients, 7 (21%) had bilateral PWS lesions. Eighteen (53%) had diagnoses of glaucoma. The proportion of eyes showing PWS involving both S1 and S2 was the highest (n = 15, 37%), and the frequency of glaucoma diagnosis (n = 9, 60%) was also the greatest. In eyelid involvement analysis, among the 7 eyes with only lower-eyelid lesions, 5 (83%) had glaucoma. Among the 11 eyes with only upper-eyelid lesions, however, 2 (18%) had diagnoses of glaucoma. A logistic regression model showed that the significant factors associated with glaucoma risk were greater PWS scores in S2 (odds ratio [OR]: 3.604; 95% confidence interval: 1.078-12.050; P = .037) or lower-eyelid involvement (OR: 12.816; 95% CI: 1.698-96.744; P = .013).
Among the newborns with facial PWS, 1) a greater extent of birthmarks involving the S2 area, and 2) lesions including the lower eyelid were associated with higher risk of glaucoma development within the neonatal period.
确定面部葡萄酒色斑（PWS）的大小和位置是否可以预测新生儿的青光眼风险。
回顾性队列研究。
纳入了出生后 4 周内接受过眼科检查的面部 PWS 患儿。收集了临床信息，包括面部照片、眼压、角膜直径、视盘杯盘比和 Sturge-Weber 综合征（SWS）诊断。根据面部照片评估 PWS 分布、眼睑受累情况以及根据每个胚胎面部血管分布（段[S]1、S2 和 S3）受累程度的 PWS 评分。
在 34 名患者中，有 7 名（21%）患有双侧 PWS 病变。18 名（53%）患有青光眼诊断。累及 S1 和 S2 的 PWS 眼的比例最高（n=15，37%），青光眼诊断的频率（n=9，60%）也最高。在眼睑受累分析中，在仅累及下眼睑的 7 只眼中，有 5 只（83%）患有青光眼。然而，在仅累及上眼睑的 11 只眼中，有 2 只（18%）患有青光眼诊断。逻辑回归模型显示，与青光眼风险相关的显著因素是 S2 中更大的 PWS 评分（比值比[OR]：3.604；95%置信区间：1.078-12.050；P=0.037）或下眼睑受累（OR：12.816；95%CI：1.698-96.744；P=0.013）。
在面部 PWS 的新生儿中，1）病变累及 S2 区的程度更大，2）病变累及下眼睑与新生儿期内青光眼发展的风险更高相关。
