Extent of asymmetry and unilaterality among juvenile onset primary open angle glaucoma patients
Article first published online: 3 OCT 2011
© 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 39, Issue 7, pages 633–638, September/October 2011
How to Cite
Gupta, V., Gupta, S., Dhawan, M., Sharma, A., Kapoor, K. S. and Sihota, R. (2011), Extent of asymmetry and unilaterality among juvenile onset primary open angle glaucoma patients. Clinical & Experimental Ophthalmology, 39: 633–638. doi: 10.1111/j.1442-9071.2011.02522.x
- Issue published online: 3 OCT 2011
- Article first published online: 3 OCT 2011
- Accepted manuscript online: 7 FEB 2011 10:41AM EST
- Received 13 October 2010; accepted 16 January 2011.
- inter-eye asymmetry;
- interocular asymmetry;
- juvenile glaucoma;
- juvenile onset glaucoma
Background: Juvenile onset open angle glaucoma (JOAG) due to its rarity is not well characterized. We aimed to assess the extent of interocular asymmetry of baseline intraocular pressure (IOP), disc morphometry and visual field defects at presentation in patients with primary JOAG.
Design: Retrospective, single-centre, hospital-based study.
Participants: Fifty-two consecutive JOAG patients who presented with glaucomatous optic neuropathy in at least one eye, without any secondary causes of glaucoma.
Methods: Participants were evaluated for baseline clinical features. The optic disc parameters were measured using scanning laser ophthalmoscopy (Heidelberg Retina Tomograph). Reliable and reproducible visual field tests using standard 30-2 Humphrey automated perimetry were analysed.
Main Outcome Measures: Interocular asymmetry of baseline IOP, vertical cup:disc ratio and mean deviation.
Results: Fourteen patients (27%) had glaucomatous optic neuropathy in only one eye at initial presentation; the fellow eyes of which had IOP <21 mmHg in eight whereas six had IOP >21 mmHg. In 20 out of 52 patients (39%) one eye remained perimetrically unaffected. Patients presenting with bilateral optic neuropathy were found to be significantly younger (24.4 ± 10.6 years) in age compared to those with unilateral optic neuropathy (32 ± 8.2 years) (P = 0.02).
Conclusions: One-fourth of primary JOAG patients present as a unilateral optic neuropathy with 60% of these having normal IOP in the fellow eyes. Primary JOAG may present with considerable asymmetry with a small proportion presenting as a unilateral disease.