Clinical outcomes in children and adolescents referred for increased cup:disk ratio at a tertiary referral center

PURPOSE To report clinical outcomes and risk factors for glaucoma in children and adolescents referred for increased cup:disk ratios (CDRs) to a tertiary referral center. METHODS This retrospective, single-center study examined all pediatric patients evaluated for increased CDR at Wills Eye Hospital. Patients who had previous known ocular disease were excluded. Demographic data, including sex, age, and race/ethnicity were recorded, as were baseline and follow-up ophthalmic examination findings, including intraocular pressure (IOP), CDR, diurnal curve, gonioscopy findings, and refractive error. Risks of glaucoma diagnosis based on these data were analyzed. RESULTS A total of 167 patients were included, of whom 6 were found to have glaucoma. Despite more than 2 years' follow-up on 61 patients, all glaucoma patients were identified within the first 3 months of evaluation. Baseline IOP was statistically significantly higher in glau-comatous patients than nonglaucomatous patients (28 +/- 7 vs 15 +/- 4, resp. [P = 0.0002]), as was maximum IOP on diurnal curve (24 +/- 3 vs 17 +/- 3 [P = 0.0005]). CONCLUSIONS In our study cohort, diagnosis of glaucoma was apparent in the first year of evaluation. Baseline IOP and maximal IOP on diurnal curve were found to be statistically significantly associated with glaucoma diagnosis in pediatric patients referred for increased CDR.

Automated summary

This study aimed to report the clinical outcomes and risk factors for glaucoma in children and adolescents referred for increased cup:disk ratios (CDRs) to a tertiary referral center. A total of 167 patients were included, of whom 6 were found to have glaucoma. Diagnosis of glaucoma was apparent within the first three months of evaluation, and baseline intraocular pressure (IOP) and maximum IOP on diurnal curve were significantly associated with glaucoma diagnosis in these pediatric patients.