원발성 선천 녹내장 환자의 시력예후 및 약시요인 분석

Visual Outcome in Children With Congenital Glaucoma

Purpose: To evaluate the prognosis of vision and the development of amblyopia in primary congenital glaucoma patients. Methods: The author reviewed 38 eyes of 22 primary congenital glaucoma patients and evaluated variables such as age at time of surgery and at the last visit, preoperative IOP, Cup-to-disc(CD) ratio, corneal diameter, refractive error, axial lengths and IOP, CD ratio and visual acuity at the last visit. According to visual acuity, the patients were divided into 3 groups, good (＞0.5), fair (0.1~0.5), and poor (＜0.1). The amblyopia was defined when BCVA was below 0.8 and no evidence of progression of glaucoma. There were 4 types of amblyopia: deprivation, anisometropic, strabismic and organic. The author compared the 3 groups and evaluated factors affecting the vision as well as the prevalence of amblyopia. Results: There were 17 eyes in the good group, 4 eyes in the fair group and 17 eyes in the poor group (p＜0.05). Amblyopia developed in 17 eyes with 7 eyes showing deprivation amblyopia. Anisometropic and organic amblyopia were each found in 4 eyes, and strabismic amblyopia was found in 2 eyes. The postoperative IOP and CD ratio and preoperative CD ratio were significantly lower in the good group than the other groups (p＜0.05). Conclusions: Final VA was poor in 45% of eyes with primary congenital glaucoma, and amblyopia developed in 45% of these eyes. The prognosis for vision may be related to the treatment of glaucoma and amblyopia.