Alshigari Rayan, Freidi Alia, Souru Ches, Edward Deepak P, Malik Rizwan
Glaucoma Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Department of Mathematics, Lebanese International University, Beirut, Lebanon.
Am J Ophthalmol. 2021 Apr;224:238-245. doi: 10.1016/j.ajo.2020.12.014. Epub 2021 Jan 6.
To evaluate the baseline features associated with blindness in a cohort of children with primary congenital glaucoma (PCG) from a hospital registry.
Retrospective clinical cohort study.
Setting: Observational cohort study. StudyPopulation: The registry included all children who presented to our tertiary care institute between 1995 and 2014 with a diagnosis of childhood glaucoma. ObservationProcedure: Baseline characteristics at initial presentation of children with PCG in the registry who were blind at the last follow-up were compared with those who were not blind, using bivariate and then multivariate regressions to account for potential confounders. MainOutcomeMeasures: Blindness was defined as a best-corrected visual acuity of 3/60 (20/400) or worse in the better eye at the final follow-up.
The eligible sample consisted of 196 children with a mean age of 9.54 ± 22.44 months at presentation. After a mean ± standard deviation follow-up of 8.49 ± 3.85 years, 20 (10.2%) children were blind. The baseline demographic factors, intraocular pressure, horizontal corneal diameter, spherical equivalent, axial length, and corneal thickness, were similar for the "blind" and "not blind" groups (P > .05). In the multivariate regression, only the severity of corneal opacification remained significantly (P < .001) associated with the risk of blindness (odds ratio = 4.05; 95% confidence interval: 1.89-8.85).
Corneal clouding is a predictor of future blindness in children with PCG. Children with severe corneal clouding may need more aggressive intraocular pressure control, closer follow-up, and earlier counseling.
通过医院登记系统评估一组原发性先天性青光眼（PCG）患儿失明相关的基线特征。
回顾性临床队列研究。
设置：观察性队列研究。研究人群：该登记系统纳入了1995年至2014年间在我们三级医疗机构就诊并被诊断为儿童青光眼的所有患儿。观察程序：将登记系统中最后随访时失明的PCG患儿初次就诊时的基线特征与未失明患儿的基线特征进行比较，采用双变量然后多变量回归分析以考虑潜在混杂因素。主要观察指标：失明定义为最后随访时较好眼最佳矫正视力为3/60（20/400）或更差。
符合条件的样本包括196名患儿，就诊时平均年龄为9.54±22.44个月。平均±标准差随访8.49±3.85年后，20名（10.2%）患儿失明。“失明”组和“未失明”组的基线人口统计学因素、眼压、角膜水平直径、等效球镜度、眼轴长度和角膜厚度相似（P>.05）。在多变量回归中，只有角膜混浊的严重程度与失明风险仍有显著相关性（P<.001）（比值比=4.05；95%置信区间：1.89 - 8.85）。
角膜混浊是PCG患儿未来失明的一个预测指标。角膜混浊严重的患儿可能需要更积极地控制眼压、更密切的随访和更早的咨询。
