Clinical and genetic aspects of glaucoma associated with congenital aniridia

Congenital aniridia is a hereditary congenital malformation of the visual organ with an autosomal dominant type of inheritance. The prognosis for vision largely depends on the development and progression of multiple complications (glaucoma, keratopathy, and aniridia fibrotic syndrome) at different ages.

AIM: To identify the most significant risk factors for glaucoma development and a poor prognosis associated with congenital aniridia.

MATERIAL AND METHODS: Seventy-three children (146 eyes) with PAX6-associated aniridia aged 0–16 yr were examined, with 41 males (56.2%) and 32 females (43.8%). The follow-up period of patients ranged from 2 to 6 yr. Thirty-five (47.9%) patients had complete aniridia, and 38 (52.1%) patients had partial aniridia. All patients underwent a comprehensive ophthalmological and molecular genetic examination.

RESULTS: Glaucoma developed in 28.8% of children. Anomalies in the anterior chamber angle (ACA) structure were detected in most patients with congenital aniridia, both with and without glaucoma. However, the relationship between the ACA and the timing of the manifestation of glaucoma was revealed. Furthermore, according to our study, the presence of glaucoma increases the risk of keratopathy progression.

CONCLUSION: In a molecular genetic study, the presence of deletions in the 3'-cis-regulatory region of the PAX6 gene was a predictor of glaucoma development.