Clinical Course and Predictors of Glaucoma Conversion in Pediatric Ocular Hypertension without Ocular or Systemic Risk Factors.
Pediatric ocular hypertension without other risk factors sometimes progresses to glaucoma.
Clinical Course and Predictors of Glaucoma Conversion in Pediatric Ocular Hypertension without Ocular or Systemic Risk Factors.
To characterize the long-term clinical course of pediatric ocular hypertension in patients without associated ocular or systemic risk factors and identify predictors of glaucoma conversion.
Pediatric patients evaluated as glaucoma suspects for ocular hypertension at the Johns Hopkins Wilmer Eye Institute between January 1, 2005, and June 1, 2024.
Compared with non-converters, converter eyes had higher baseline IOP (28.53 ± 12.25 vs 24.32 ± 4.76 mmHg, P<0.001), larger cup-to-disc ratio (cup-to-disc ratio) (0.59 ± 0.22 vs 0.43 ± 0.23, P<0.001), and were more frequently male (61.5% vs 41.1%, P=0.014).
In multivariable analysis, male sex (adjusted odds ratio [aOR] 3.19, P=0.006), higher baseline IOP (aOR 1.12 per mmHg, P=0.001), larger baseline cup-to-disc ratio (aOR 1.32 per 0.1 increase, P=0.001), Goldmann applanation (aOR 3.17, P=0.010), and Tono-Pen tonometry (aOR 5.48,P=0.013) were associated with conversion.
Isolated pediatric ocular hypertension is not uniformly benign and carries a measurable long-term risk of glaucoma conversion.
Higher baseline IOP, larger cup-to-disc ratio, and male sex were associated with progression and may assist in early risk stratification.
These findings support individualized surveillance and treatment strategies, with closer monitoring and earlier therapeutic consideration for children with higher-risk baseline features.