BACKGROUND
Newborn primary congenital glaucoma is an unusual and important subtype of primary congenital glaucoma. Affected patients typically manifest specific signs that facilitate its recognition at birth and become important in the assessment and determination of appropriate treatment for this severe expression of primary congenital glaucoma.
PATIENTS AND METHODS
The medical records of 35 patients with newborn primary congenital glaucoma were reviewed to determine its clinical manifestations and response to therapy. The published literature related to newborn primary congenital glaucoma was reviewed and referenced.
RESULTS
Newborn primary congenital glaucoma is recognized at birth because of the associated corneal opacification. Ocular examination reveals anterior segment abnormalities of the cornea, iris, and filtration angle as well as related elevated intraocular pressure. Genetic analysis of a subset ofpatients with newborn primary congenital glaucoma confirmed its relationship with the less severe infantile form of primary congenital glaucoma, which is characterized by favorable results after goniosurgery. In contrast, goniosurgery was found to have unfavorable results and be less successful compared with trabeculectomy and glaucoma drainage tube shunts as initial therapy for newborn primary congenital glaucoma.
CONCLUSIONS
Newborn primary congenital glaucoma is an important subtype of primary congenital glaucoma. It can be differentiated from the more frequent and familiar infantile type by history and careful anterior segment examinations to enable and support appropriate choices for its successful surgical treatment.
J Pediatr Ophthalmol Strabismus 2005;42:333-341.
AUTHORS
Dr. Walton is from the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. Ms. Katsavounidou is from the Massachusetts Institute of Technology, Cambridge, Massachusetts.
Originally submitted July 8, 2005.
Accepted for publication August 30, 2005.
Address reprint requests to David S. Walton, MD, 2 Longfellow Place, Suite 201, Boston, MA 02114-2224.
The authors thank Dr. John Wright, Dr. Richard Robb, and Dr. William Boger for providing valuable additional information regarding their experiences with the histopathology of newborn primary congenital glaucoma.
Presented in part as the 2005 Chandler-Grant Lecture for the Chandler-Grant Society at the bimonthly meeting of the New England Ophthalmological Society; May 20, 2005.
The authors have no industry relationships to disclose.
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