LAUSR

PURPOSE To determine if the size and location of facial port-wine stain (PWS) can predict glaucoma risk for neonates. DESIGN Retrospective cohort study METHODS: Children with facial PWS who had undergone ophthalmologic examination within four weeks of their birth were included. Clinical information including facial photograph, intraocular pressure, corneal diameter, optic-disc cup-to-disc ratio, and Sturge-Weber syndrome (SWS) diagnosis were collected. Based on facial photographs, PWS distribution, eyelid involvement, and PWS scores according to degree of involvement in each embryonic facial vasculature distribution (segment [S]1, S2 and S3) were evaluated. RESULTS Among the 34 patients, 7 (21%) had bilateral PWS lesions. Eighteen (53%) were diagnosed as glaucoma. The proportion of eyes showing PWS involving both S1 and S2 was the highest (n=15, 37%) and the frequency of glaucoma diagnosis (n=9, 60%) was also the greatest. In eyelid involvement analysis, among the 7 eyes with lower-eyelid lesion only, 5 (83%) had glaucoma. Among the 11 eyes having upper-eyelid lesion only, however, 2 (18%) were diagnosed with glaucoma. A logistic regression model showed that the significant factors associated with glaucoma risk were greater PWS score in S2 (OR 3.604; 95% CIs 1.078-12.050; P = 0.037) or lower-eyelid involvement (OR 12.816; 95% CIs 1.698-96.744; P = 0.013). CONCLUSIONS Among the newborns with facial PWS, (1) greater extent of birthmarks involving the S2 area, and (2) lesions including the lower eyelid were associated with higher risk of glaucoma development within the neonatal period.