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      Comparisons of Risk Factors and Visual Field Changes between Juvenile-Onset and Late-Onset Primary Open-Angle Glaucoma

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          Purpose: To identify the differences in risk factors and visual field (VF) changes between juvenile primary open-angle glaucoma (JOAG) and late-onset chronic open-angle glaucoma (COAG). Methods: The demographic and presenting clinical data of 27 JOAG and 30 COAG patients were retrospectively reviewed. Comparisons between the two groups were performed using Mann-Whitney U test, Wilcoxon signed-rank test, and Fisher’s exact test. Results: A family history of glaucoma (37%) and a history of steroid usage (14.8%) were identified in JOAG patients only. The JOAG patients had a longer axial length (p < 0.001) and more often a myopic refractive state (p < 0.001) than the COAG patients. Patients with COAG showed a deeper (p = 0.016) and a more extensive (p = 0.008) defect in the superior than in the inferior hemifield, as well as a deeper (p = 0.016) and a more extensive (p = 0.001) defect in the superior than in the inferior arcuate area, while JOAG patients showed symmetric VF defects between the superior and inferior hemifields. Purely diffuse VF depression is more common in JOAG than in COAG patients (p = 0.03). Conclusions: JOAG patients demonstrated more axial myopic changes than patients with COAG as well as a pattern of superior-inferior symmetric VF defects. Axial myopia may play a critical role in the pathogenesis of JOAG.

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          The relationship between glaucoma and myopia

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            Juvenile glaucoma, race, and refraction.

             D G Lotufo,  R Ritch,  L SZMYD (1989)
            Of 68 patients who presented between the ages of 10 and 35 years with elevated intraocular pressure, 25 were classified as juvenile ocular hypertension and 43 as juvenile primary open-angle glaucoma. Blacks constituted a greater proportion of the primary open-angle glaucoma patients (47%) than of the ocular hypertensives (20%) and in both groups presented at younger ages than did whites. Myopia was present in 59% of the ocular hypertensives and 73% of the primary open-angle glaucoma patients, of whom 39% had more than 6 diopters of myopia. All eyes of black patients with more than 3 diopters of myopia had glaucomatous defects compared with 52% of such eyes of white patients. Our data suggest that myopia is strongly associated with juvenile open-angle glaucoma and that young black patients with elevated intraocular pressure, especially when myopic, are more susceptible to glaucomatous damage than are whites.

              Author and article information

              S. Karger AG
              February 2002
              14 March 2002
              : 216
              : 1
              : 27-32
              Department of Ophthalmology, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan
              48293 Ophthalmologica 2002;216:27–32
              © 2002 S. Karger AG, Basel

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              Page count
              Figures: 1, Tables: 4, References: 21, Pages: 6
              Original Paper · Travail original · Originalarbeit


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