Indian Journal of Clinical and Experimental Ophthalmology 2021;7(2):448–451
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Indian Journal of Clinical and Experimental Ophthalmology
Journal homepage: www.ijceo.org
Case Report
Juvenile open angle glaucoma –A case series study
Shams Mohammed Noman
1,
*
1
Dept. of Ophthalmology, Bangabondhu Shekh Mujib Medical University, Dhaka, Bangladesh
ARTICLE INFO
Article history:
Received 21-04-2021
Accepted 21-04-2021
Available online 30-06-2021
Keywords:
Juvenile open angle glaucoma
Trabeculectomy
ABSTRACT
Background: Juvenile open angle glaucoma is a rare form of glaucoma that differs from primary open
angle glaucoma in its age of onset and magnitude of intraocular pressure.
Juvenile open angle glaucoma has its onset between 3-40 years of age with relatively high intraocular
pressure.
Purpose: For the documentation and describe clinical manifestations management and outcome of
management of the patients diagnosed as Juvenile open-angle glaucoma at the glaucoma department,
CEITC, Chittagong, Bangladesh.
Materials and Methods: This is a hospital based prospective observational case series review. 20 patients
who were diagnosed as Juvenile open-angle glaucoma from November 2010 to December 2011 were
included in this study.
Patient particulars history with main causes of hospital presentations were recorded. Ophthalmic
examinations and management given were documented. Similar relevant details were recorded for different
follow-up periods.
Results: 40 eyes of 20 patients were included in this study. There were 16 male and 4 female. All cases
were bilateral. Age more than 18yrs. (18-35) in 16 patients and below 18yrs. (5-18) in 4 patients. 15 patients
came from rural area and 5 patients from urban. Pretreatment average IOP in the both eyes was 32±3mmhg,
which was 15±1mmhg after treatment. 24 of 40 eyes were presented with advance field defects. 85% (17
patients) had myopic refractive error. In 18eyes pre treatment presenting visual acuity was <6/60 and >6/60
in the rest of the eyes. Visual acuity was improved after treatment. In 21 patients (53%) IOP was controlled
with 2-3 medications. In 19 eyes (48%) IOP was controlled with filtration surgery.
Conclusion: As Juvenile open-angle glaucoma presented with high IOP and advance field defect, early
diagnosis, appropriate investigations and medical or surgical management is mandatory to stabilize IOP
and to prevent progression of field defects.
© This is an open access article distributed under the terms of the Creative Commons Attribution
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1. Introduction
Juvenile open-angle glaucoma (JOAG) which has an age
at onset of (5-35) years tends to be more aggressive. It is
usually resistant to medical therapy and is associated with
more severe visual impairment than primary open angle
glaucoma.
1
The estimated prevalence of JOAG ranges from 0.38to 2
in 100000 in individuals between 4-20 years of age and 4
* Corresponding author.
E-mail address: drshams_noman@yahoo.com (S. M. Noman).
percent of child hood glaucoma.
Identifying risk factor are important because this
information may lead to development of strategies for
disease screening and prevention and may be useful in
identifying persons for whom close medical supervision
is indicated. Thick compact tissue in the angle represents
an immature development of the trabecular meshwork and
may be one of the primary cause of increase intraocular
pressure in Juvenile glaucoma
2
the more extensive the
immaturity, the earlier the glaucoma will become manifest.
GLCIA, the first open angle glaucoma gene, was initially
https://doi.org/10.18231/j.ijceo.2021.089
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