Structural changes of the ciliary body and ciliary processes measured by ultrasound biomicroscopy of primary congenital glaucoma in comparison to glaucoma following congenital cataract surgery

https://doi.org/10.1016/j.jaapos.2019.08.049Get rights and content

Introduction

Glaucoma is an important cause of pediatric blindness. Our study aims to better understand ciliary body structural parameters and differences in patients with Primary Congenital Glaucoma (PCG) and Glaucoma Following Congenital Cataract Surgery (GFCCS).

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Methods

This is an ongoing prospective comparative study conducted at Children's National Medical Center and University of Maryland comparing patients with PCG and GFCCS undergoing exam under anesthesia. Eyes without any ocular pathology are used for comparison. Longitudinal ultrasound biomicroscopy (UBM) was performed for all patients. Image analysis was performed using ImageJ software to measure 6 structural parameters of the ciliary body (CB) and ciliary processes (CP).

Results

Nine PCG eyes and 6 GFCCS eyes were compared with 25 control eyes. CP integrated density and CP area were significantly lower in patients with glaucoma compared to controls (P = 0.0428 and 00485, resp.). PCG CP thickness and CP integrated density were also significantly lower in comparison to GFCCS (P = 0.0041 and 0.000024 resp.). However, CB thickness was significantly lower in patients with GFCCS compared to PCG (P = 0.01129).

Discussion

Our study demonstrates quantifiable differences between the CB and CP in patients with PCG in comparison to both normal eyes and GFCCS. Quantifying the anatomical variance of the CB and CP in patients with pediatric glaucoma opens opportunity to better understand these disease processes.

Conclusions

UBM can be used to better understand the anatomy of patients with pediatric glaucoma. A better understanding of anatomical and structural changes may help guide therapeutic surgical approaches to these diseases.

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