Clinical Characteristics of Juvenile-Onset Open Angle Glaucoma

Abstract

Juvenile open- angle glaucoma (JOAG) is an uncommon form of primary open –angle glaucoma, with earlier onset (3 to 40 years of age), higher IOP(1), and more severe visual field loss compared with adult onset primary open- angle glaucoma (POAG). Many studies report that this form of glaucoma typically demonstrates an autosomal dominant inheritance pattern. The myocilin (MYOC) gene is identified abundantly through linkage analysis in the trabecular meshwork (TM) of the affected patients.(2) (3). In this study, we retrospectively demonstrated the clinical characteristics in patients with JOAG, to provide medical treatment and future prevention and awareness in clinics of this disease. Patients with JOAG are diagnosed at an early age and therefore have a longer expectancy than the typical glaucoma patient. And this can cause visual impairment and blindness which can significantly impair the patient’s quality of life and limit daily living activities. This retrospective study at Dr. Shroff’s Charity Hospital from April 2019 to December 2020 included 80 glaucoma patients, revealing 3.4% with juvenile-onset open-angle glaucoma (JOAG). Notably, 92.5% had bilateral JOAG, and 75% were male. Most patients (87%) lacked a family history of glaucoma, and 91.10% had no systemic diseases. Chief complaints included blurring of vision (38%), ocular pain (9%), and various others. Refractive analysis showed 46% mild myopia, 23% moderate myopia. Visual impairment was absent in 83% of eyes, and cupping severity varied. Disc size was mostly medium (75%), and rim loss severity varied. Among 154 eyes, 131 received medical and surgical treatment, with a mean intraocular pressure (IOP) of 19.2105 mm Hg. The remaining 23 patients had a mean IOP of 19.133 mm Hg. These findings provide concise insights into JOAG patient characteristics and treatment patterns. Key words: Juvenile open-angle glaucoma (JOAG), Juvenile onset open-angle glaucoma, Glaucoma.