New research highlights risk factors for glaucoma progression in enaffected eyes of PCG patients

One-third of initially unaffected fellow eyes in patients with unilateral primary congenital glaucoma (PCG) eventually develop elevated intraocular pressure or glaucoma over long-term follow-up, with larger corneal diameter being a strong predictor of disease progression, according to a study.

The study followed 54 patients for a median duration of 8.2 years, with follow-up periods ranging from 5 to 25.5 years. Over this period, 17 patients (32%) experienced progression to bilateral disease, 8 patients (15%) developed ocular hypertension, and 9 patients (17%) developed glaucoma in the fellow eye.

Among the unaffected fellow eyes, those with larger corneal diameters exceeding 12 mm after at least 5 years of follow-up were 10 times more likely to progress to bilateral disease (P = 0.01; OR = 9.5 [95% CI, 1.7-54.3]). The presence of a patent supraciliary channel was more frequently associated with fellow eyes compared to affected eyes as seen on AS-OCT (OR = 1.4 [95% CI, 0.46-4.68]).

These findings emphasize the importance of long-term monitoring and early detection in managing PCG.

Reference
Majumdar A, Panigrahi A, Singh A, et al. Progression to bilaterality in unilateral primary congenital glaucoma. J AAPOS. 2024;103967. doi: 10.1016/j.jaapos.2024.103967. Epub ahead of print. PMID: 38971397.