Publication: Evaluation of central corneal thickness, anterior chamber depth and axial length among juvenile open angle glaucoma patients
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Date
2022
Authors
Aziz, Ahmad Marwan
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Abstract
INTRODUCTION Juvenile open-angle glaucoma (JOAG) is a subset of primary open-angle glaucoma (POAG), characterized by a pattern of autosomal dominant inheritance. Diagnosed at early age, patients with JOAG are expected to have longer life expectancy. They are usually associated with more severe and rapidly progressive disease. JOAG has insidious onset and is usually detected late stage of the disease with typically advance optic nerve damage and intraocular pressure of more than 40mmHg. Early detection particularly due to screening of family members with positive family history of JOAG. Literature on morphologic features of JOAG is limited. By studying those features will help clinician in determining which morphologic features associated with progression of the disease. While family members with positive morphologic features particularly will be screened more regularly, preventing late detection of the disease. OBJECTIVE The study aims to evaluate central cornea thickness (CCT), anterior chamber depth (ACD) and axial length (AL), in JOAG patients, and its association with JOAG severity. METHODS A prospective cross-sectional study was conducted from June 2020 until November 2021 involving 3 tertiary ophthalmology centres. The study involved 2 groups of patients which is JOAG groups and control group (age-sex matched). They were grouped into mild, moderate and severe group using modified AGIS scoring system with reliable and reproducible SITA standard 24-2 Humphrey visual field results. A-scan was performed in order to measure ACD, and AL. AS-OCT was performed to measure CCT. RESULTS A total of 120 patients were recruited in this study, whereby 60 patients were included in JOAG group and 60 patients without ocular comorbidities were included in control group. Slightly more male patients 53.3% (n = 32) in JOAG group, and 51.7% (n = 31) in control group. Mean age is 27.97±7.1 in both groups. From the JOAG group, at their first presentation, majority were from severe stage 68.3% (n = 41) followed by early stage 26.7% (n = 16), and moderate stage 5% (n = 3). While at recruitment, majority were from severe stage as well which increased to 70% (n = 42), followed by early stage 16.7% (n = 10), and moderate stage 13.3% (n = 8). We found that statistically significant changes of severity from first presentation and at recruitment (p=<0.001). There was significant difference in CCT (556.23±28.93mm, p=0.008) and AL (25.16±1.63mm, p= <0.001) between JOAG and control group. Multiple linear regression showed that presenting IOP, and AL were associated with severity of JOAG. CONCLUSIONS There was a significant mean difference in CCT and AL between JOAG and control groups. There was a significant positive linear relationship between CCT and AL with JOAG. We concluded that presenting IOP and AL were associated with severity of JOAG
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