Childhood glaucoma

儿童青光眼
  • 文章类型: Observational Study
    这项研究的目的是确定自我感知的关联,运动技能,和年轻学龄儿童青光眼(CG)的临床特征。这是一项横断面观察研究。从学龄前到二年级的孩子,包括CG(N=19),弱视儿童(CA,N=28),和控件(N=32),完成了儿童运动评估电池第2版(MABC-2)的手动灵巧,瞄准和捕捉量表,包括手动灵巧,瞄准和捕捉,和平衡。CG,CA,他们的父母完成了幼儿感知能力和社会接受度的图片量表,分别,评估孩子的认知能力,同行接受,身体素质,和母亲的接受。Kruskal-WallisH测验和Bonferroni事后测验比较了各组之间的运动技能。Spearman的相关分析评估了运动技能之间的相关性,自我感知,和临床特征。CG报告的同行接受度低于CA(P=0.040),CG的父母报告的认知能力低于CG报告的认知能力(P=0.046)。与对照组相比,CG的瞄准和捕捉性能较差,和平衡(P=0.018和P=0.001),CA的平衡性能较差(P=0.009)。CG和CA之间的运动技能相当。对于CG,年龄较大与瞄准和捕捉能力较差相关(r=-0.620,P=0.005),更好的眼睛的最佳矫正视力与更高的手动灵活性和平衡能力相关(r=-0.494,P=0.032,r=-0.516,P=0.024),青光眼持续时间较长与手动灵活性较差相关(r=-0.487,P=0.034)。
    结论:青光眼和弱视对儿童的日常运动技能有显著的负面影响。视力较好的眼睛的敏锐度是影响运动运动的重要因素。
    背景:ClinicalTrials.gov标识符,ChiCTR2100050415。
    背景:•儿童早期的心理健康状况影响其未来人格和身体发育的发展。青光眼的预后和治疗可能严重损害受影响儿童的心理健康发展。然而,对儿童青光眼的心理方面和运动方面的探索是有限的。
    背景:•青光眼儿童的运动技能和自我感知发育受损,特别是在同伴社会化方面。
    The purpose of the study was to determine the associations of self-perception, motor skills, and clinical features of young school-age children with glaucoma (CG). This is a cross-sectional observational study. Children from preschool to second grade, including CG (N = 19), children with amblyopia (CA, N = 28), and controls (N = 32), completed the Manual Dexterity and Aiming and Catching Scales of the Movement Assessment Battery for Children-2nd edition (MABC-2), including Manual Dexterity, Aiming and Catching, and Balance. CG, CA, and their parent completed the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children, respectively, assessing the child\'s cognitive competence, peer acceptance, physical competence, and maternal acceptance. The Kruskal-Wallis H test and Bonferroni post hoc test compared motor skills among groups. Spearman\'s correlation analysis evaluated the correlations between motor skills, self-perception, and clinical features. The CG reported lower peer acceptance than CA (P = 0.040), and the parents of CG reported lower cognitive competence than CG reported (P = 0.046). Compared with controls, CG had worse performance of Aiming and Catching, and Balance (P = 0.018 and P = 0.001), and CA had worse performance of Balance (P = 0.009). The motor skills were comparable between CG and CA. For CG, older age correlated with worse competence of Aiming and Catching (r =  - 0.620, P = 0.005), better best-corrected visual acuity of better-seeing eye correlated with higher competence of Manual Dexterity and Balance (r =  - 0.494, P = 0.032, and r =  - 0.516, P = 0.024), and longer duration of glaucoma correlated with worse competence of Manual Dexterity (r =  - 0.487, P = 0.034).
    CONCLUSIONS:  Glaucoma and amblyopia have significant negative impacts on children\'s daily motor skills. The acuity of a better-seeing eye is an important factor influencing motor movement.
    BACKGROUND: ClinicalTrials.gov identifier, ChiCTR2100050415.
    BACKGROUND: • The state of mental health in early childhood influences the development of their future personality and physical development. The prognosis and management of glaucoma may seriously impair the mental health development of the affected children. However, the exploration of psychological aspects and motor movement of childhood glaucoma was limited.
    BACKGROUND: • Children with glaucoma have impaired motor skills and self-perception development, especially in terms of peer socialization.
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  • 文章类型: Case Reports
    目的:报告1例原发性先天性青光眼患者行房角镜辅助经腔小梁切开术(GATT)。
    方法:一个三岁的男孩,表现为眼内压升高。尽管存在虹膜和虹膜过程延伸到Schwalbe的线,GATT成功执行。
    结论:GATT对于原发性先天性青光眼可能是成功的,即使在最初看不到房角结构的情况下。
    OBJECTIVE: To report a case of gonioscopy-assisted transluminal trabeculotomy (GATT) in a patient with primary congenital glaucoma.
    METHODS: A three-year-old boy who presented with buphthalmos and elevated intraocular pressure. Despite the presence of iris and iris processes extending to Schwalbe\'s line, GATT was performed successfully.
    CONCLUSIONS: GATT may be successful with primary congenital glaucoma even when angle structures are not initially visible.
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  • 文章类型: Systematic Review
    Objectives: Retinal nerve fiber layer (RNFL) thickness has been detected by numerous studies about alterations and abnormalities in childhood glaucoma, but these studies have yielded inconsistent results about the RNFL thinning region. The investigation of characteristics of RNFL in pediatric patients would contribute to the deep understanding of the neuropathic mechanisms of childhood glaucoma. Thus, the degree of thinning in different quadrants deserves further discussion and exploration. Method: A systematic literature search was conducted using the Cochrane Central Register of Controlled Trials, Medline, Embase, and PubMed databases to identify clinical studies published from inception to April 1, 2021. Results: Ten studies were included in this review with a total of 311 children with glaucoma and 444 in nonglaucomatous controls. The results revealed that average peripapillary RNFL (pRNFL) thickness was attenuated in pediatric patients with glaucoma [weighted mean difference (WMD) = -20.75; 95% CI -27.49 to -14.01; p < 0.00001]. Additionally, pRNFL thickness in eight quadrants (superior, inferior, temporal, nasal, superotemporal, inferotemporal, superonasal, and inferonasal) had different levels of reduction in the pediatric group of glaucoma. Conclusion: This study indicates that eight regions of RNFL thickness show various degrees of thinning in childhood glaucoma. However, caution is required in the interpretation of results due to marked heterogeneity. Future studies, especially larger samples and multicenter, need to confirm our results.
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  • 文章类型: Journal Article
    OBJECTIVE: To evaluate the epidemiological features, clinical interventions, and outcomes of paediatric glaucoma in Hong Kong.
    METHODS: Retrospective chart review.
    METHODS: Clinical data from the medical records of all patients under 18 years of age diagnosed with glaucoma from January 2008 to December 2017 at a university-affiliated, tertiary referral centre were collected. The patients\' demographics, etiological distribution, clinical interventions, and outcomes were analysed.
    RESULTS: A total of 33 subjects (53 eyes) were identified, 30 (49 eyes) of whom were Chinese. Primary glaucoma accounted for 21.2% of subjects, while 78.8% were diagnosed with secondary glaucoma. The most common subtype was juvenile-onset open angle glaucoma, followed by Sturge-Weber Syndrome related glaucoma. The most commonly performed surgical interventions were tube-shunt surgery (Ahmed Glaucoma Valve) and transscleral cyclophotocoagulation. Most eyes had significant reduction in intraocular pressure after medical or surgical intervention, but deterioration of visual acuity remained common.
    CONCLUSIONS: Most cases of childhood glaucoma in Hong Kong are secondary rather than primary, similar to other regions with low incidence of parental consanguinity. The large proportion of secondary glaucoma which generally has poorer prognosis, is reflected by the frequency of multiple surgery, and a high incidence of visual deterioration despite significant intraocular pressure reduction in most eyes.
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  • 文章类型: Journal Article
    BACKGROUND: This study aimed to study the long-term surgical outcomes of combined trabeculotomy-trabeculectomy (CTT) using the modified Safer Surgery System in treating childhood glaucoma at a tertiary medical center in Taiwan.
    METHODS: Retrospective, consecutive, noncomparative case series. We retrospectively reviewed medical records of 42 pediatric patients (age 0-18 years) who had CTT performed on their 65 eyes using the modified Safer Surgery System. The study period spanned 18 years (from January 1, 1997, to December 31, 2014). We evaluated the outcome in terms of postoperative intraocular pressure (IOP), axial length growth, disc cupping reversal, and use of antiglaucoma medications. The surgical success was rated using the Kaplan-Meier survival analysis and based on the incidence of complications.
    RESULTS: The mean follow-up period was 85.05 ± 32.17 months (range 14-200). After operation, IOP dropped significantly from 35.76 ± 9.44 mmHg (mean ± SD) to 16.18 ± 7.20 mmHg together with a significant reversal of optic disc cupping. Similarly, the use of antiglaucoma medications was also significantly reduced in number from 1.26 ± 0.50 to 0.43 ± 0.70. Most of the axial lengths of the eyes measured at the last follow-up visit showed growths within the average ± 2 SDs in comparison with the healthy, age-matched population. After surgery, the qualified success rate was 90.77% at the end of the first year, 90.77% at the second year, 87.64% at the fifth year, 84.51% at the 10th year, and 81.38% at the 15th year. No serious intraoperative or postoperative complications were found.
    CONCLUSIONS: For Taiwanese children, the combined trabeculotomy-trabeculectomy using the modified Safer Surgery System offered an efficient and safe surgical option for treating glaucoma with long-term satisfactory control of IOP.
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