Clinical correlates to the goniodysgensis among juvenile-onset primary open-angle glaucoma patients.
OBJECTIVE
To evaluate gonioscopic features and relate them to clinical characteristics in eyes with juvenile-onset primary open-angle glaucoma (JOAG).


METHODS
Goniophotographs of unrelated JOAG patients, presenting between 10-40 years of age, were evaluated and compared with 60 healthy subjects in the same age group. Age of onset, family history of glaucoma, highest untreated IOP and visual field defect (mean deviation) were analyzed and correlated with the gonioscopic features among JOAG patients.


RESULTS
Of 126 patients included in the study, 44 (34 %) had a normal open angle (group 1), while 82 (66 %) had developmental anomalies (group 2). Developmental anomalies of the angle were classified as: high iris insertion with or without prominent iris processes (n=42), a featureless angle (n=30), and those with prominent iris processes alone (n=10). There was no difference in age of onset (group 1, 30.5 ± 7 years and group 2, 26.3 ± 9.6 years) (p=0.07) or the untreated IOP at presentation (group 1; 36 ± 12.5 mmHg and group 2, 38.8 ± 12.3 mmHg; p=0.37) between the groups. However, those with angle anomalies presented with a greater visual field defect (MD -23.5 ± 10.5 vs -14.8 ± 13 dB; p=0.02) compared to those with normal appearing angle.


CONCLUSIONS
While two thirds of JOAG patients present with developmental anomalies of the angle, one third have normal appearing angles. High insertion of the iris is the most common form of gonio dysgenesis observed. Those with angle dysgenesis are more likely to present with severe disease.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. gupta_v20032000@yahoo.com
Viney
V
Gupta
Rajat M
RM
Srivastava
Aparna
A
Rao
Manik
M
Mittal
John
J
Fingert
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000869:Anterior Eye Segment / Q000002:abnormalities* / Q000473:pathology; D002648:Child; D005124:Eye Abnormalities / Q000175:diagnosis*; D005192:Family Health; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007498:Iris / Q000002:abnormalities / Q000473:pathology; D008297:Male; D015995:Prevalence; D014786:Vision Disorders / Q000175:diagnosis; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields; D055815:Young Adult