Suicide risk in juvenile open angle glaucoma patients

AIM:To investigate the association between juvenile open angle glaucoma(JOAG)and mental health among Koreans.METHODS:This study used nationally representative data from the 8th Korea National Health and Nutrition Examination Survey(KNHANES)2021.Glaucoma diagnosis followed the International Society of Geographical and Epidemiological Ophthalmology criteria based on glaucomatous structural defects,visual field defects,corrected vision,and intraocular pressure.As outcomes,suicidal behaviors,psychiatric counseling,and depression were evaluated through mental health questionnaires.Odds ratios(ORs)with 95%confidence intervals(CIs)were estimated using logistic regression models,adjusting for covariates.RESULTS:Among 7090 participants,3446 met the inclusion criteria for analysis,and 88(2.6%)were diagnosed with open angle glaucoma(OAG).After adjusting for age,sex,and best-corrected visual acuity(VA),participants with OAG were revealed to have significantly higher odds of suicidal behaviors(i.e.,ideation,planning,or attempts)compared with those without OAG(OR:2.70;95%CI:1.12-6.54;P=0.028).This association remained significant after further adjustments for socioeconomic status,lifestyle factors,and presence of chronic conditions(P=0.031 and 0.035,respectively).However,there was no significant difference for the other two outcomes,psychiatric counseling and depression.An age-stratified analysis revealed a stronger association between OAG and suicidal behaviors in younger JOAG participants(<40y)than in older OAG participants(≥40y;OR:3.80 vs 2.22;95%CI:0.79-18.22 vs 0.56-8.80,respectively).CONCLUSION:OAG patients show a higher risk of suicidal behaviors than those without glaucoma particularly in JOAG patients.

Agreement in identification of glaucomatous progression between the optic disc photography and Heidelberg Retina Tomography in young glaucomatous patients

AIM:To evaluate concordance between the clinical assessment of glaucomatous progression of the optic disc photography and progression identified by Heidelberg Retina Tomograph(HRT)in patients with suspected primary juvenile open angle glaucoma(JOAG).METHODS:Optic disc photographs and corresponding HRTⅡseries were reviewed.Optic disc changes between first and final photographs were noted as well as progression identified by HRT topographic change analysis(TCA)and rim area regression line(RARL)Agreement between progression indentified by photography and HRT methods was assessed.Progression,determined from optic disc photographs by consensus assessment was used as the reference standard.RESULTS:A total of 31 patients(59 eyes)with suspected JOAG were studied.Agreement for progression/no progression between TCA and photography was obtained in 4 progressing eyes and 38stable eyes(71.19%,k=0.11).Agreement for progression/no progression between RARL and photography was detected in 5 progressing eyes and in 34 stable eyes(66.10%,k=0.15).The number of HRT per patient was statistically higher in the progressing group(P=0.034).CONCLUSION:Agreement for detection of longitudinal changes between photography and HRT analysis was poor.One way to improve the chance of discovery of the progression could be increasing the number of HRT examinations.

Profile of pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital

Background The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients 〈18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital. Methods The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed. Results A total of 1 142 eyes of 734 pediatric patients （500 males） were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5：1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group （n=125, 17.03%）. Traumatic glaucoma was the third most common subtype （n=81, 11.03%）. The type of surgery was related to the subtype of glaucoma. Conclusions Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.