Retrospective analysis of paediatric glaucoma at a tertiary referral centre in Hong Kong

Purpose To evaluate the epidemiological features, clinical interventions, and outcomes of paediatric glaucoma in Hong Kong. Study design Retrospective chart review. Methods Clinical data from the medical records of all patients under 18 years of age diagnosed with glaucoma from January 2008 to December 2017 at a university-affiliated, tertiary referral centre were collected. The patients' demographics, etiological distribution, clinical interventions, and outcomes were analysed. Results A total of 33 subjects (53 eyes) were identified, 30 (49 eyes) of whom were Chinese. Primary glaucoma accounted for 21.2% of subjects, while 78.8% were diagnosed with secondary glaucoma. The most common subtype was juvenile-onset open angle glaucoma, followed by Sturge-Weber Syndrome related glaucoma. The most commonly performed surgical interventions were tube-shunt surgery (Ahmed Glaucoma Valve) and transscleral cyclophotocoagulation. Most eyes had significant reduction in intraocular pressure after medical or surgical intervention, but deterioration of visual acuity remained common. Conclusion Most cases of childhood glaucoma in Hong Kong are secondary rather than primary, similar to other regions with low incidence of parental consanguinity. The large proportion of secondary glaucoma which generally has poorer prognosis, is reflected by the frequency of multiple surgery, and a high incidence of visual deterioration despite significant intraocular pressure reduction in most eyes.