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Clinical profile and outcome of early surgery in neonatal-onset glaucoma presenting over a 5-year period
  1. Sushmita Kaushik1,
  2. Deepika Dhingra1,
  3. Atul Arora1,
  4. Mini P Singh2,
  5. Savleen Kaur1,
  6. Gunjan Joshi1,
  7. Sagarika Snehi1,
  8. Gaurav Gupta1,
  9. Surinder Singh Pandav1
  1. 1Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Sushmita Kaushik, Ophthalmology, Post Graduate Institute of Medical Education and Research Advanced Eye Center, Chandigarh 160012, India; sushmita_kaushik{at}yahoo.com

Abstract

Background Neonatal-onset glaucoma (NOG) is a severe form of childhood glaucoma and is not always due to primary congenital glaucoma (PCG). Due to advances in neonatal care, the incidence of NOG is rising, but it remains an under-reported entity. The objective of the paper was to study the clinical profiles, surgical and visual outcomes of NOG at least 1 year following early surgery.

Methods Prospective interventional cohort study at a tertiary care referral centre. Babies with NOG, who presented between January 2013 and December 2017, had a history suggestive of disease onset within 1 month of birth, and underwent surgery by 3 months of age, were prospectively enrolled. Those who completed a 1-year follow-up after surgery were analysed.

Results 94 eyes of 53 babies were analysed. 35 (66%) had PCG. Neonatal congenital ectropion uveae, congenital rubella syndrome, Peter’s anomaly and Sturge-Weber syndrome comprised the non-PCG group. The mean age at presentation and surgery was 24.8±21.9, and 36.7±29.9 days. Additional glaucoma surgery was required in 43 of the 94 eyes (45.7%). PCG had significantly better outcomes than other glaucomas at all time points. 28.3% of eyes had good vision (LogMar (0–0.5)), 34.7% had moderate visual impairment (LogMar 0.7–1.0) and 16% were blind (LogMar <1.62) .

Conclusion Our study shows that NOG does not always have a dismal prognosis. A small but significant proportion could have other underlying conditions than PCG. Timely surgery and rigorous amblyopia therapy resulted in good outcomes in terms of intraocular pressure control and vision in this cohort.

  • glaucoma
  • child health (paediatrics)
  • intraocular pressure

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Footnotes

  • Contributors The principal investigator SK and coauthor DD had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AA, SK, GJ, SS and GG are responsible for manuscript preparation, drafting and patient care. SSP, acknowledged for his supervision; and MPS, for help in diagnostic testing of the patients.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Ethics approval Ethics clearance was obtained from the Institutional Ethics Committee, Postgraduate Institute of Medical Education and Research, Chandiagrh (vide NK/6226/Study/20) and it adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All relevant data with the primary author and shared in the manuscript.

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