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Epidemiology and long-term outcomes of primary congenital glaucoma: a population-based study

Eye (2023)Cite this article

Subjects

Abstract

Background/Objectives

to establish the incidence, prevalence and long-term outcomes of primary congenital glaucoma (PCG) in Northern Ireland’s general and Irish Traveller (IT) populations over a 59-year period.

Subjects/Methods

chart review of all PCG cases in Northern Ireland between 1962 and 2020. Incidence and prevalence were calculated with the aid of national population statistics. Long-term outcomes were analysed for eyes with at least 5 years follow up. Visual outcomes were stratified into groups: good–VA ≥ 6/12; moderate–VA 6/12 to 6/60, poor–VA < 6/60. Kaplan–Meier analysis was constructed to determine the probability of eyes retaining a good visual outcome over time. Outcomes of different surgeries were compared with regard to final vision, re-operations and complications.

Results

57 PCG cases were identified between 1962 and 2020. Overall incidence was 3.4 per 100,000 live births. PCG prevalence in general and IT populations in 2019 was 4.3 per 100,000 and 238 per 100,000, respectively. Sixty eyes had sufficient data for long-term outcome analysis with a mean of 20.5 years follow up, 58% of which had good final visual outcome. Fifty-seven percent of eyes required multiple surgeries. Visual outcomes between trabeculectomies and tubes were comparable; however, there were more serious complications and reoperations associated with tubes.

Conclusions

Incidence of PCG in NI is similar to Great-Britain and Ireland; however, PCG appears to be particularly prevalent within IT community. Although a good visual outcome can be achieved in the majority of patients, a subset of cases remain challenging to manage despite surgical advances.

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Fig. 1

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Northern Ireland birth/population statistics and data relating to the Irish Traveller population utilised in this study are available online through the Northern Ireland Statistics and Research Agency (see references [12,13,14]).

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Acknowledgements

Professor Sir Peng T Khaw, Miss Maria Papadopoulos, Mr John L Brookes and Ms Rosie Brennan, co-managers of our patients with PCG outside of the Belfast Trust.

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Authors and Affiliations

  1. Department of Ophthalmology, Royal Victoria Hospital, Belfast Trust Health and Social Care Northern Ireland, Belfast, Northern Ireland

    Robert John Nutt, Mohammad Samir Dowlut & Eibhlin McLoone

  2. School of Electronics, Electrical Engineering and Computer Science, Queen’s University Belfast, Belfast, Northern Ireland

    Seán Francis McLoone

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  1. Robert John Nutt
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  2. Mohammad Samir Dowlut
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  3. Seán Francis McLoone
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  4. Eibhlin McLoone
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Contributions

EM was responsible for instigating, supervising and reviewing this work. MD collected much of the data up until 2012 and contributed to the first draft. SM advised on and performed statistical analysis. RN collected study data and was the main author of this article.

Corresponding author

Correspondence to Robert John Nutt.

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The authors declare no competing interests.

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Nutt, R.J., Dowlut, M.S., McLoone, S.F. et al. Epidemiology and long-term outcomes of primary congenital glaucoma: a population-based study. Eye (2023). https://doi.org/10.1038/s41433-023-02382-6

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