Distribution, characteristics of primary and secondary congenital glaucoma in Saudi Arabia

This analysis of data from a large glaucoma registry in Saudi Arabia describes the similarities and differences between primary and secondary congenital glaucoma patients. Interesting findings included a low overall percentage of corneal haze.

The authors write that the distribution of primary and secondary congenital glaucoma in a large series has not been addressed in Middle Eastern patients. They analyzed data from the congenital glaucoma registry at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, to determine the demographic and clinical characteristics of primary and secondary congenital glaucoma that presented to the hospital between 2001 and 2003. The hospital is a major eye care provider in Saudi Arabia and sees patients with congenital glaucoma referred from all Saudi regions and the surrounding Gulf states.

A total of 325 eyes of 180 patients were included. Eighty percent of patients had primary congenital glaucoma. Most primary and secondary congenital glaucoma patients had bilateral disease (82.6 percent and 74.3 percent, respectively), which is similar to what has been reported worldwide. The mean age of presentation of primary and secondary congenital glaucoma (3.8 ± 10.7 months and 4.3 ± 7.9 months, respectively) was also comparable to that reported globally. A positive family history of congenital glaucoma was present in 30 percent, and almost 60 percent in both groups had a history of consanguinity.

Primary congenital glaucoma was equally distributed by sex but secondary congenital glaucoma was 1.5-fold more common in male patients. The authors note that this is different from other populations. Studies reporting sex distribution of congenital glaucoma have suggested that the disease was more prevalent in male subjects in the United States, Eastern and Western Europe, and Australia, whereas in Japan it was more common in female subjects.

Only 20 percent of all patients with congenital glaucoma had secondary congenital glaucoma. The mean IOP and corneal diameter were comparable in both groups but axial length was significantly longer in primary congenital glaucoma and the cup-to-disc (C/D) ratio greater in secondary congenital glaucoma.

Severe haze was seen in 12.2 percent of primary congenital glaucoma eyes and in 22.6 percent of secondary congenital glaucoma eyes. In the primary congenital glaucoma group, corneal haze showed a significant relationship with most clinical parameters. In primary congenital glaucoma, a positive correlation was noted between age at presentation and increasing corneal diameter and axial length but a negative relationship was noted with C/D ratio and corneal haze, whereas for secondary congenital glaucoma only axial length was positively correlated with age.