Investigation of Possible Antenatal and Perinatal Risk Factors in Patients with Congenital Epiphora

Year 2024, Volume: 14 Issue: 2, 156 - 161, 29.08.2024

Elif Sedanur Utlu , Bahadır Utlu , Mustafa Bayraktar

Abstract

Aim: We aimed to investigate the effective factors to increase treatment options in patients with congenital nasolacrimal duct obstruction (LDO).
Materyal and Methods: Our study was planned retrospectively. The patients admitted to Erzurum Regional Training and Research Hospital Family Medicine Outpatient Clinic with symptoms such as watering, burring, swelling in the sac area, chronic conjunctivitis < In 200 children under 4 years of age, information on maternal age, mode of conception, gender, birth weight, mode of delivery, presence of multiple pregnancies, sibling history, duration of hospitalization, need for invasive mechanical ventilation, maternal pre-eclampsia, gestational DM, and bilateral or unilateral occlusion, need for surgery, number of surgeries, presence of anisometropia, when epiphora started and when it ended were collected and evaluated.
Results: Of the children included in the study, 52% (n=103) were male and 48% (n=95) were female. It was shown that complaints such as watering, redness, and burring due to congenital nasolacrimal duct obstruction mostly started in the first weeks (7.1%), and most of these complaints were relieved by massaging the sac area and topical drops (90.3%) without surgical intervention. There were no significant statistical differences between children with and without congenital epiphora in terms of gender, multiple pregnancies, mode of delivery, delivery week, need for postnatal intensive care, mother’s mode of conception, maternal age and chronic diseases (p>0.05). Significant differences were found in birth weight and the presence of positive sibling history (p<0.05).
Conclusion: This study was conducted to evaluate the association of congenital epiphora with possible antenatal and perinatal risk factors. It was concluded that low birth weight and positive sibling history may be involved in the etiopathogenesis of epiphora, but it was concluded that studies on this subject should be conducted by reaching large populations.

Keywords

Epiphora, Caesarean section, Hasner’s valve, Lacrimal Duct Embryology

References

• 1. MacEwen, C. J., and U. O’Colmain. “The lacrimal system.” Pediatric Ophthalmology and Strabismus. 3rd ed. Philadelphia: Elsevier Saunders (2005): 285-94.
• 2. Wong, Rupa Krishnamurthy, and Deborah K. VanderVeen. “Presentation and management of congenital dacryocystocele.” Pediatrics 122.5 (2008): e1108-e1112.
• 3. Jones, L. T., and J. L. Wobig. “Congenital anomalies of the lacrimal system.” Surgery of the Eyelids and Lacrimal System. Birmingham, AL: Aesculapius (1976): 157-173.
• 4. Wong, Jamie F., et al. “A multidisciplinary approach to atypical lacrimal obstruction in childhood.” Ophthalmic plastic and reconstructive surgery 15.4 (1999): 293-298.
• 5. Edmond, J. C., and Ronald V. Keech. “Congenital nasolacrimal sac mucocele associated with respiratory distress.” (1991): 287-289.
• 6. Nemet AY. The aetiology of epiphora: a multifactorial issue. Semin Ophthalmol 2016;31:275-9.
• 7. Wang JC, Cunningham MJ. Congenital dacryocystocele: is there a familial predisposition? Int J Pediatr Otorhinolaryngol. 2011 Mar;75(3):430-2. doi: 10.1016/j.ijporl.2010.11.026. Epub 2010 Dec 23. PMID: 21185090.
• 8. Katowitz JA, Kropp TA. Congenital abnormalities of the lacrimal drainage system. In: Hornblass A, ed. Oculoplastic, Orbital and Reconstructive Surgery. Baltimore: Williams and Wilkins, 1990: 1397-1416.
• 9. Bukhari A. Etiology of tearing in patients seen in an oculoplastic clinic in Saudi Arabia. Middle East Afr J Ophthalmol 2013;20:198-200.
• 10. Williams B, Johnson D, Hurst J, Kratky V. Patterns and causes of epiphora referrals to a tertiary oculoplastic practice. Can J Ophthalmol 2014;49:180-2
• 11. Pezzoli M, Patel BC. Dacryostenosis. 2022 Jul 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023
• 12. Weiss, A. H., Baran, F., & Kelly, J. P. (2012). Congenital nasolacrimal duct obstruction. Archives of Ophthalmology, 130(7). https://doi.org/10.1001/archophthalmol.2012.36
• 13. Moscato EE, Kelly JP, Weiss A. Developmental anatomy of the nasolacrimal duct: implications for congenital obstruction. Ophthalmology. 2010;117(12):2430-243420656354PubMedGoogle ScholarCrossref
• 14. Thiery JP, Sleeman JP. Complex networks orchestrate epithelial-mesenchymal transitions. Nat Rev Mol Cell Biol. 2006;7(2):131-14216493418PubMedGoogle ScholarCrossref
• 15. Rand, P.K., Ball, W.S. and Kulwin, D.R., Congenital nasolacrimal mucoceles: C.T. evaluation. Radiology, 173 (1989) 691-694.
• 16. Alakuş, M. F., Dag, U., Balsak, S., Erdem, S., Öncül, H., Akgöl, S., & Diri, H. (2019). Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery? European Journal of Ophthalmology, 30(6), 1228-1231. https://doi. org/10.1177/1120672119889522
• 17. Spaniol K, Stupp T, Melcher C, et al. Association between congenital nasolacrimal duct obstruction and delivery by cesarean section. Am J Perinatol 2015; 32(3): 271–276.
• 18. Kakizaki H, Takahashi Y, Kinoshita S, et al. The rate of symptomatic improvement of congenital nasolacrimal duct obstruction in Japanese infants treated with conservative management during the 1st year of age. Clin Ophthalmol 2008; 2(2): 291–294.
• 19. Wolfs GM and van Leeuwen M. Electromyographic observations on the human uterus during labour. Acta Obstet Gynecol Scand Suppl 1979; 90: 1–61.
• 20. Silva ME, Oliveira DA, Roza TH, et al. Study on the influence of the fetus head moulding on the biomechanical behaviour of the pelvic floor muscles, during vaginal delivery. J Biomech 2015; 48(9): 1600–1605.
• 21. Sathiamoorthi, S., Frank, R. D., & Mohney, B. G. (2018). Incidence and clinical characteristics of congenital nasolacrimal duct obstruction. British Journal of Ophthalmology, 103(4), 527-529. https://doi.org/10.1136/bjophthalmol-2018-312074
• 22. Wang JC, Cunningham MJ. Congenital dacryocystocele: is there a familial predisposition? Int J Pediatr Otorhinolaryngol. 2011 Mar;75(3):430-2. doi: 10.1016/j.ijporl.2010.11.026. Epub 2010 Dec 23. PMID: 21185090.
• 23. H.M. Traquair, Chronic dacryocystitis. Its causation and treatment, Arch. Ophthal.26 (1941) 165–180.
• 24. E. Richardson, C. Davison, A.T. Moore, Colobomatous microphthalmia with midfacial clefting: part of the spectrum of branchio-oculo-facial syndrome? Ophthal. Genet. 17 (1996) 59–65.
• 25. Aldahash FD, Al-Mubarak MF, Alenizi SH, Al-Faky YH. Risk factors for developing congenital nasolacrimal duct obstruction. Saudi J Ophthalmol. 2014 Jan;28(1):58-60. doi: 10.1016/j. sjopt.2013.09.007. Epub 2013 Oct 10. PMID: 24526860; PMCID: PMC3923192.
• 26. Świerczyńska M, Tobiczyk E, Rodak P, Barchanowska D, Filipek E. Success rates of probing for congenital nasolacrimal duct obstruction at various ages. BMC Ophthalmol. 2020 Oct 8;20(1):403.