Improving Long-term Intraocular Pressure and Visual Outcomes in Eyes with Aniridic Glaucoma

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2021 Jul 30

PMID 34328551

Citations 2

Authors

Ramanjit Sihota

Harathy Selvan

Kishan Azmira

Tanuj Dada

Ajay Sharma

Amisha Gupta

Ashish Upadhyay

Affiliations

Soon will be listed here.

Abstract

Purpose: To study the long-term intraocular pressure (IOP) and visual outcomes in treated aniridic glaucoma.

Methods: A retrospective chart review of patients with aniridia and glaucoma, with ≥ 2-year follow-up, was performed. Eyes in early glaucomatous stages were medically managed, while moderate-severe stage eyes underwent a trabeculectomy with mitomycin-c (MMC). Success was termed 'complete' when average final IOP was ≤ 18 mmHg without usage of glaucoma medications, and 'qualified' when with/without topical glaucoma therapy. A significant change in vision was defined as > 2-line change on Snellen vision chart or > 0.2 change in logMAR units in in either direction (better or worse).

Results: Thirty-five eyes of 20 patients were included. The mean duration of follow-up was 7.29 ± 5.75 years. Associated ocular anomalies were present in 19 eyes (54.29%). Twelve eyes (34.28%) were maintained on medical management, while 23 eyes (65.71%) had undergone a trabeculectomy with MMC. The mean baseline IOP was 31.46 ± 6.34 mmHg, and mean IOP on last follow-up was 13.25 ± 5.82 mmHg, p < 0.001. Seventy-five percent of the medically managed eyes achieved an IOP ≤ 18 mmHg. 52.17% and 95.65% of the surgically treated eyes achieved 'complete' and 'qualified' success respectively. The median best corrected visual acuity (BCVA) at baseline was 1.48(0.6-2) logMAR units and on final follow-up was 1.3 (0.48-5) logMAR units, p = 0.21. Fifty percent of the eyes remained stable, 35.71% showed an improvement and 14.29% a deterioration of > 0.2 logMAR units. Patients with a longer follow-up (> 10 years) and those who had undergone a trabeculectomy with MMC were more likely to show good IOP control (p = 0.003; p = 0.004 respectively).

Conclusion: Aniridic glaucoma can be managed efficiently by medications in early glaucomatous neuropathy, and with trabeculectomy augmented with mitomycin-C and releasable sutures for more advanced glaucomas, offering favourable long-term IOP control, visual stability and safety.

Citing Articles

Congenital aniridia beyond black eyes: From phenotype and novel genetic mechanisms to innovative therapeutic approaches.

Daruich A, Duncan M, Robert M, Lagali N, Semina E, Aberdam D Prog Retin Eye Res. 2022; 95:101133.

PMID: 36280537 PMC: 11062406. DOI: 10.1016/j.preteyeres.2022.101133.

Clinical and molecular aspects of congenital aniridia - A review of current concepts.

Tibrewal S, Ratna R, Gour A, Agarkar S, Dubey S, Ganesh S Indian J Ophthalmol. 2022; 70(7):2280-2292.

PMID: 35791108 PMC: 9426064. DOI: 10.4103/ijo.IJO_2255_21.

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