Risk Factors for Blindness in Children With Primary Congenital Glaucoma - Follow-up of a Registry Cohort

PURPOSE: To evaluate the baseline features associated with blindness in a cohort of children with primary congenital glaucoma (PCG) from a hospital registry. DESIGN: Retrospective clinical cohort study. METHODS: SETTING: Observational cohort study. STUDY POPULATION: The registry included all children who presented to our tertiary care institute between 1995 and 2014 with a diagnosis of childhood glaucoma. OBSERVATION PROCEDURE: 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. MAIN OUTCOME MEASURES: 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. RESULTS: 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). CONCLUSION: 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. (C) 2020 Elsevier Inc. All rights reserved.