American Journal of Medicine and Medical Sciences

p-ISSN: 2165-901X    e-ISSN: 2165-9036

2026;  16(3): 905-906

doi:10.5923/j.ajmms.20261603.12

Received: Feb. 11, 2026; Accepted: Feb. 27, 2026; Published: Mar. 4, 2026

 

Anatomical and Functional Characteristics of the Anterior Chamber Angle in the Diagnosis of Primary Congenital Infantile Glaucoma

Khamroeva Yu. A.1, Narzullayeva D. U.2, Karimova D. B.3, Jo’rayeva S. O.4

1PhD, Associate Professor, Department of Ophthalmology and Pediatric Ophthalmology, Tashkent State Medical University, Tashkent, Uzbekistan

2DSc, Assistant Professor, Department of Ophthalmology and Pediatric Ophthalmology, Tashkent State Medical University, Tashkent, Uzbekistan

3PhD, Assistant Professor, Department of Ophthalmology and Pediatric Ophthalmology, Tashkent State Medical University, Tashkent, Uzbekistan

4Master’s Student, Tashkent State Medical University. Tashkent, Uzbekistan

Copyright © 2026 The Author(s). Published by Scientific & Academic Publishing.

This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/

Abstract

To study the features of the anterior chamber angle in the diagnosis of primary congenital infantile glaucoma. Eighteen patients (36 eyes) aged 9 to 11 years (9.3±1.6) with an established diagnosis of primary congenital infantile glaucoma (PCIG) were examined. Group I (initial stage) included 5 patients (10 eyes), Group II (developed stage) 4 patients (8 eyes), Group III (advanced stage) 4 patients (8 eyes), and Group IV (terminal stage) 5 patients (10 eyes). Diagnosis, goniodysgenesis assessment, and intraocular pressure (IOP) evaluation were performed according to the classification of N.A. Kachan and T.K. Toykuliev. Gonioscopy was performed using a Goldmann three-mirror lens with a slit lamp. In Group I, 28% of eyes demonstrated Type I pretrabecular form persistent dense pectinate ligament. In Group II, 11% showed Type I pretrabecular form corresponding to Grade I goniodysgenesis (E.G. Sidorenko and M.G. Mirzayants), and 11% of eyes demonstrated Type II trabecular form (Barkan’s membrane). In Group III, 22% of eyes revealed Type II trabecular form abnormal attachment of Brücke’s muscle. In Group IV, 14% of eyes had Type II trabecular form trabecular underdevelopment, and 14% showed abnormal sinus development. The proposed classification is dynamic, covers nearly all aspects of glaucoma development and course, allows determination of the localization of impaired aqueous humor outflow, and enables a pathogenetically grounded surgical approach in primary congenital infantile glaucoma.

Keywords: Congenital infantile glaucoma, Intraocular pressure, Goniodysgenesis, Anterior chamber angle, Gonioscopy

Cite this paper: Khamroeva Yu. A., Narzullayeva D. U., Karimova D. B., Jo’rayeva S. O., Anatomical and Functional Characteristics of the Anterior Chamber Angle in the Diagnosis of Primary Congenital Infantile Glaucoma, American Journal of Medicine and Medical Sciences, Vol. 16 No. 3, 2026, pp. 905-906. doi: 10.5923/j.ajmms.20261603.12.

Article Outline

1. Introduction
2. Materials and Methods
3. Results
4. Conclusions

1. Introduction

Accurate knowledge of the etiology, pathogenesis, and clinical manifestations of childhood glaucoma, along with proper assessment of the degree of compensation and dynamics of the glaucomatous process, allows timely and comprehensive diagnostic measures and determination of optimal patient management [1,2,3]. Juvenile glaucoma as an independent disease was first mentioned in 1913 by Lohlun [4]. Later, in Russia, it was described as part of primary congenital glaucoma within the classification of A.P. Nesterov and A.Ya. Bunin [5].
Timely diagnosis plays a leading role in preventing blindness and visual impairment, as disease progression rapidly leads to decreased visual function. Pronounced trophic changes occur in the posterior segment of the eye, optical media, drainage system, and sclera [6-9].
Elevated IOP and impaired aqueous humor outflow may be caused by trabeculopathy with elements of goniodysgenesis. The disease may also be associated with connective tissue dysplasia and various syndromic manifestations [1,10].
Sidorenko (2003) proposed differentiating congenital glaucoma based on anterior chamber angle changes. However, transferring adult primary glaucoma classifications to pediatric ophthalmology is not justified due to differences in etiopathogenesis [11,12].
The classification proposed by N.A. Kachan and T.K. Toykuliev (2004) is based on extensive clinical material (126 patients, 208 eyes, aged 8 days to 15 years, follow-up up to 20 years) and includes all forms of goniodysgenesis [13,14].
Despite advances, questions remain regarding the pathogenesis of congenital glaucoma. Pathomorphological studies of the eye’s drainage system are of particular interest for clarifying disease mechanisms.
Aim. To study the characteristics of the anterior chamber angle in the diagnosis of primary congenital infantile glaucoma.

2. Materials and Methods

Clinical studies were conducted at the Department of Ophthalmology of the multidisciplinary pediatric clinic of TSMU. Eighteen patients (36 eyes) aged 9–11 years (9.3±1.6) with PCIG were examined. Group distribution: initial stage – 5 patients (10 eyes); developed stage – 4 (8 eyes); advanced stage – 4 (8 eyes); terminal stage – 5 (10 eyes). Different stages in paired eyes were observed in 4 children; identical stages in both eyes in 12 patients; unilateral process in 2 patients. All patients underwent standard ophthalmological examination including visometry, biomicroscopy, gonioscopy, ophthalmoscopy, refractometry, tonography, and tonometry.

3. Results

Preoperative visual acuity averaged 0.3±0.56. IOP in the developed stage was subnormal up to 26.8±2.01 mmHg; in the advanced stage – elevated up to 28.8±1.01 mmHg; in the terminal stage – very high at 34.01±1.53 mmHg. Axial length was 23.6±1.2 mm (developed stage), 24.6±2.1 mm (advanced stage), and 25.7±2.2 mm (terminal stage). Optic disc excavation ratio (E/D) averaged 0.4±0.05 (developed), 0.7±0.1 (advanced), and 0.95±0.002 (terminal).
Gonioscopy assessed angle width, trabecular meshwork position relative to the scleral spur, pigmentation, pectinate ligament, vessels, mesodermal remnants, and goniosynechiae.
Group I: 28% – Type I pretrabecular form (persistent dense pectinate ligament).
Group II: 11% – Type I pretrabecular form (Grade I goniodysgenesis); 11% – Type II trabecular form (Barkan’s membrane).
Group III: 22% – Type II trabecular form (abnormal Brücke’s muscle attachment).
Group IV: 14% – Type II trabecular form (trabecular underdevelopment); 14% – abnormal sinus development.
Anatomical and functional underdevelopment of the anterior chamber angle is crucial in choosing optimal treatment strategy.

4. Conclusions

The study of anterior chamber angle features is essential in diagnosing primary congenital infantile glaucoma. Early detection directly determines treatment effectiveness and the success of blindness prevention through timely and targeted therapy.

References

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