Childhood Glaucoma Profile in a Brazilian Tertiary Care Center Using Childhood Glaucoma Research Network Classification

Purpose: To apply the Childhood Glaucoma Research Network (CGRN) classification in children from a pediatric glaucoma outpatient clinic in a tertiary Brazilian care center to better understand the prevalence and the demographic and clinical characteristics of each subtype of childhood glaucoma. Methods: This was a retrospective study in which medical records were collected from patients assisted in childhood glaucoma's clinic at the Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo from January 2010 to January 2018. The initial diagnosis and new diagnosis according to CGRN classification were collected. In addition, age, sex, visual acuity, and affected eye were recorded. Results: From 624 ophthalmic consultations in the clinic, 496 had confirmed diagnosis of childhood glaucoma or glaucoma suspect. Mean age at diagnosis of the entire group was 3.62 +/- 4.23 years (range, 0 to 17 y). Two hundred eight-one (56.65%) of all patients were male and 349 patients (81.16%) had bilateral disease. All patients fit 1 of the 7 categories of the new classification. In all, 48.59% of diagnoses were changed upon reclassification. According to CGRN classification, 220 patients (44.35%) had primary glaucoma (juvenile open-angle glaucoma and primary congenital glaucoma); 210 patients (42.34%) had secondary glaucoma (glaucoma associated with nonacquired ocular anomalies; glaucoma associated with nonacquired systemic disease or syndrome; glaucoma associated with acquired condition; and glaucoma following cataract surgery); and 66 patients (13.31%) were glaucoma suspect. The most common diagnoses found were primary congenital glaucoma with 218 cases (43.95%) and the last common diagnosis was juvenile open-angle glaucoma with 2 cases (0.40%). Conclusion: The CGRN classification provides a useful method for classifying childhood glaucoma. A single, standardized classification system is important for diagnosis and management these patients, in addition, may improve physician communication, and future research.

Automated summary

The study applied the CGRN classification system to investigate pediatric glaucoma patients in a Brazilian outpatient clinic, revealing demographic and clinical differences among different subtypes of childhood glaucoma. The findings provide useful insights for future research, diagnosis, and management of pediatric glaucoma patients.