Systemic, hereditary causes identified in pediatric bilateral cataract cases
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In children with bilateral cataracts, systemic and hereditary causes were more often identified than in unilateral cases, in which ocular associations were more often made, according to a study.
“There are few reports specifying associated systemic diagnoses in large cohorts of children undergoing cataract surgery,” Bharti R. Nihalani-Gangwani, MD, and colleague wrote in a poster presentation at the virtual American Association for Pediatric Ophthalmology and Strabismus annual meeting.
The researchers conducted a chart review of 727 patients younger than 21 years who underwent cataract surgery at a tertiary referral center during a 25-year period. Patients were classified by laterality and then further differentiated by systemic or ocular associations.
Cause of cataract was identified in 66% of patients in the bilateral cataract group and in 55% in the unilateral cataract group. Heredity causes (21.8%), syndromic/genetic/metabolic causes (23.8%) and treatment for cancer or systemic steroid treatment (14.7%) accounted for cataract in the majority of the 408 children with bilateral cataracts. Ocular dysmorphology drove most cases (48.9%) in the 319 children with unilateral cataract.
In the bilateral cases, Down syndrome (5.6%), Lowe syndrome (1.7%) and Marfan syndrome (4.2%) were the most prevalent systemic anomalies. The ocular associations most prevalent in unilateral cases were ocular trauma (20%), persistent fetal vasculature (19.5%) and retina or optic nerve anomalies (5.3%).
“Clinicians should be more aware of systemic diagnoses among children to guide systemic workup, provide framework for follow-up of such patients and for prediction of development of cataract in the fellow eye,” Nihalani-Gangwani and colleagues said.
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Nihalani-Gangwani BR, et al. Systemic diagnoses in pediatric patients undergoing cataract surgery. Presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 9-11, 2021 (virtual meeting).
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