الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Purpose; To study the fellow eye of unilateral congenital glaucoma (PCG) patients
with optical coherence tomography angiography (OCT-A), comparing them to the
normal age-matched controls.
Design; prospective cross-sectional study.
Patients and Methods; Thirty two cases with unilateral congenital glaucoma in
group A and 32 normal controls in group B were recruited in the study with age 4 –
14 years old. Both groups were investigated by OCT-A comparing Foveal
avascular zone (FAZ) area, Central macular thickness (CMT), Cup to disc (CD)
ratio, Retinal nerve fiber layer (RNFL) thickness, Choroidal thickness (CT), Vessel
density (VD) in the Superficial vascular complex (SVC) and Deep vascular
complex (DVC) in both 3mm and 6 mm scans, and VD of optic nerve head and
peripapillary area.
Results; Sixty four eyes were included in the study with age range 4-14 years for
both groups. Equal sex distribution in group B, while group A had 22 (68.8%)
males. The CD ratio was higher in group A compared to group B (range 0.13±0.14
in A and 0.07±0.09 in B p-value 0.039). Mean RNFL thickness was 113.81±15.4
μm and 117.41±13.19 μm in group A and B respectively. Mean CT in group A was
396.81±39.98 μm and 375.34±41.72 μm in group B (P-value 0.04). Mean CMT
was 235.69±17.96 in group A and 234.16±15.2 in group B. The FAZ area was
smaller in group A (0.3± 0.1mm
2
) than group B (0.35±0.13mm2
) (p-value 0.093).
The VD at fovea in group A in 3mm scan was (19.41±6.88%) and group B was
(15.95±5.87%) (p-value 0.034). The VD in the superficial whole image in 6mm
scan was lesser in group A (49.42±2.58%) than group B (50.74±2.6%) (p-value
0.045). Both cases and controls were not significantly different regarding the VD
at the disc area.
Conclusion; The fellow eye of unilateral PCG cases are not entirely normal with
less vascular density by OCT-A and needs long term follow up.
Introduction and Aim of The Work
2
Introduction
Primary congenital glaucoma (PCG) is a rare but potentially blinding
condition affecting children globally. Worldwide incidence of PCG is reported at
approximately 1 in 10,000 live births (1). However, the incidence varies across
regions and is said to be higher in developing countries.
PCG is characterized by optic neuropathy associated with a raised intraocular
pressure (IOP) and accompanying clinical signs of optic disc cupping, disc
asymmetry, enlarged corneal diameter, corneal oedema, Haab’s striae, increasing
axial length and progressive myopia (2).
Unilateral congenital glaucoma may reach up to 40% of all PCG cases as
reported by Bayoumi, 2017 who also found that the apparently normal eyes of
these unilateral cases have high index of suspicion for developing glaucoma as
compared to normal pediatric controls (3).
The novel introduction of optical coherence tomography angiography (OCT-
A) has sparked interest in evaluating vascular changes in the retina and optic nerve
head (ONH) for diagnosis and monitoring in glaucoma (4).
OCT-A can evaluate the peripapillary vascular network easily in different
layers. In normal eyes, a dense microvascular network with no focal capillary
dropout can be observed around most healthy optic discs (5).
In pediatric age group, OCT-A managed to detect a significant decrease in
vessel density in amblyopic eyes when compared to controls as reported by sobral
et al, 2018 (6).
Yarmo_hammadi et al, 2016 found that OCT-A vessel density is lower in
glaucoma patients compared with healthy controls and glaucoma suspects and has
Introduction and Aim of The Work
3
a similar diagnostic accuracy to retinal nerve fiber layer (RNFL) thickness for
discriminating healthy subjects from glaucoma suspects and glaucoma patients(7)
.
To our knowledge there is no available data on PCG study by OCT-A, and
also no available studies on unilateral PCG as regards their fellow eyes by OCT or
OCT-A.