title: Long-term structural and functional outcomes of therapy in juvenile-onset primary open-angle glaucoma: a five-year follow-up.
abstract: OBJECTIVE
  To evaluate long-term structural and functional changes of the optic nerve head in medically and surgically treated juvenile-onset primary open-angle glaucoma (JOAG).
  
  
  METHODS
  Forty-two eyes of 42 consecutive primary JOAG patients presenting between January 2000 and January 2003. Results were analysed for long-term intra-ocular pressure (IOP) control, IOP fluctuation, disc characteristics on a Heidelberg Retinal Tomograph II and for visual field changes over a 5-year period. The parameters were compared between medically and surgically treated eyes.
  
  
  RESULTS
  The average age of the patients was 26.8 ± 6.1 years. The average baseline IOP was 35.3 ± 14.9 mm Hg. An IOP control <18 mm Hg was achieved in 84% of eyes that underwent filtering surgery (n = 17), compared to 63% on medical therapy alone (n = 25) at the end of 5 years; log rank test p = 0.38. Over 5 years, 4 eyes showed progression (9.5%) of which 3 had been medically treated and 1 had failed surgery (p = 0.45).
  
  
  CONCLUSIONS
  A tenth of JOAG eyes showed progression over 5 years, and this was more common in those treated medically. Aggressive IOP lowering may thus be needed in eyes with JOAG.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. gupta_v20032000 @ yahoo.com
authors.forename: Viney
authors.initials: V
authors.lastname: Gupta
authors.forename: Mary
authors.initials: M
authors.lastname: Ov
authors.forename: Aparna
authors.initials: A
authors.lastname: Rao
authors.forename: Ajay
authors.initials: A
authors.lastname: Sharma
authors.forename: Ramanjit
authors.initials: R
authors.lastname: Sihota
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents