Article Sidebar
Views PDF: 0
CLINICAL CHARACTERISTICS OF JUVENILE OPEN-ANGLE GLAUCOMA
Main Article Content
Abstract
Purpose: To describe the clinical characteristics of patients with juvenile open-angle glaucoma (JOAG). Patients and Methods: A cross-sectional descriptive study was conducted on patients diagnosed with JOAG at the Vietnam National Eye Hospital from June to December 2025. Results: A total of 67 eyes from 34 patients were included, with a mean age of 21.18 ± 9.42 years. The male-to-female ratio was 47.1% and 52.9%, respectively. A positive family history of glaucoma was found in 20.6% of patients. Most patients had good visual acuity (≥ 20/30: 59.7%) or fair visual acuity (20/30–20/70: 17.9%). The mean pre-treatment intraocular pressure (IOP) was relatively high at 33.51 ± 10.39 mmHg. Mean spherical equivalent refractive error was -3.02 ± 2.42 D.No eyes showed optic disc hemorrhage. β-zone peripapillary atrophy was mostly ≤ 2/4 of the disc circumference (89.5%).The vertical cup-to-disc ratio was approximately equal to the horizontal ratio. A statistically significant correlation was found between pre-treatment IOP and both age and visual acuity (p < 0.05).Eyes with normal iris crypts and normal appearing angle had the lowest pre-treatment IOP and latest onset age; eyes with normal iris crypts but featureless angle had the earliest onset age; eyes with high iris insertion and prominent deep crypts had the highest pre-treatment IOP.No significant correlation was found between pre-treatment IOP and gender, family history, spherical equivalent, or β-zone atrophy area. Conclusion: Juvenile open-angle glaucoma is essentially a group of disorders with complex and not yet fully understood pathophysiological mechanisms. Clinical features such as iris configuration and gonioscopic findings may provide clues to the underlying pathogenesis. For instance, a high iris insertion suggests a mechanism similar to congenital glaucoma and is often associated with markedly elevated intraocular pressure (IOP). In contrast, eyes with a normal-appearing anterior chamber angle on gonioscopy usually present with moderately elevated IOP, resembling the pattern observed in primary open-angle glaucoma.
Article Details
Keywords
Juvenile open-angle glaucoma, clinical characteristic
References
2. Allingham RR, Damji KF, Freedman SF, Moroi SE, Rhee DJ, Shields MB. Shields textbook of glaucoma. 6th Ed. Lippincott Williams & Wilkins; 2012.
3. Das J, Bhomaj S, Chaudhuri Z, et al. Profile of glaucoma in a major eye hospital in North India. Indian J Ophthalmol 2001;49:25–30.
4. Birla S, Gupta D, Somarajan BI, Gupta S, Chaurasia AK, Kishan A, Gupta V. Classifying juvenile onset primary open angle glaucoma using cluster analysis. Br J Ophthalmol. 2020;104:827–35.
5. Gupta V, Srivastava RM, Rao A, Mittal M, Fingert J. Clinical correlates to the goniodysgensis among juvenile-onset primary open-angle glaucoma patients. Graefes Arch Clin Exp Ophthalmol. 2013;251:1571–6. doi: 10.1007/ s00417-013-2262-2.
6. Kwun, Y., Lee, E. J., Han, J. C., & Kee, C. (2016). Clinical characteristics of juvenile-onset open angle glaucoma. Korean Journal of Ophthalmology: KJO, 30(2), 127–133. https://doi. org/10.3341/kjo.2016.30.2.127
7. Gupta, S., Singh, A., Mahalingam, K., Selvan, H., Gupta, P., Pandey, S., Somarajan, B. I., & Gupta, V. (2021). Myopia and glaucoma progression among patients with juvenile onset open angle glaucoma: A retrospective follow up study. Ophthalmic & Physiological Optics: The Journal of the British College of Ophthalmic Opticians (Optometrists), 41(3), 475–485.
8. Jerndal, T. (1978). Goniodysgenesis: a new perspective on glaucoma (A. Bill & H.-A. Hansson, Eds.). Scriptor.
9. Jonas, J. B., & Gründler, A. (1996). Optic disc morphology in juvenile primary open-angle glaucoma. Graefe s Archive for Clinical and Experimental Ophthalmology, 234(12), 750–754. https://doi.org/10.1007/bf00189356