Risk factors identified for glaucoma progression in paediatric glaucoma suspects
Reviewed by Lauren Hepworth

A retrospective case review was conducted of children (<18 years) identified as being glaucoma suspects using common clinical criteria or the Childhood Glaucoma Research Network definition. Exclusion criteria included penetrating ocular trauma, treated ocular hypertension / glaucoma and use of anti-hypertensive medication. Demographics, birth history, visit history, clinical features including intraocular pressure (IOP), cup:disc ratio, central corneal thickness and diagnostic testing including gonioscopy, perimetry, optical coherence tomography were collected from the medical records. A total of 887 children were included in the study. The most common reasons for being identified as a glaucoma suspect were the appearance of the optic nerve, family history and ocular hypertension. Of those that attended for one or more follow-up visits (55%) a total of 14 were diagnosed with glaucoma and 324 remained glaucoma suspects. Risk factors for glaucoma from the baseline assessment included raised IOP ≥24 and periocular lesion. The authors present a large sample of paediatric glaucoma suspects and presented potential risk factors for progression to glaucoma. A large proportion remained as glaucoma suspects. Within the constraints of the study it is not possible to predict the number that would progress to a glaucoma diagnosis. The authors conclude the progression to glaucoma is low and that children with high baseline IOP and periocular lesion should be considered at higher risk of progression. Further studies with longer follow-up are required to inform follow-up frequency requirements for paediatric glaucoma suspects.

Pediatric glaucoma suspects: characteristics and outcomes.
Kletke SN, Mills MD, Tomlinson LA, et al.
JOURNAL OF THE AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2022;26:236.