Eyes With End-Stagelar Glaucoma

Parrish, Richard K.

doi:10.1001/archopht.1983.01040010745008

Cited by 40 publications

(3 citation statements)

References 7 publications

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“…This has been described previously in neovascular glaucoma patients and has been attributed to possible progression of the underlying disease 7,14,19–21. Use of antivascular endothelial growth factor (anti-VEGF) drugs may improve outcomes after glaucoma surgery in eyes with neovascular glaucoma 22,23.…”

Section: Discussionmentioning

confidence: 73%

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

Shen

Salim²,

Du³

et al. 2011

OPTH

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Purpose:To compare surgical outcomes in neovascular glaucoma patients who underwent trabeculectomy with mitomycin C versus Ahmed Glaucoma Valve implantation.Patients and methods:This was a retrospective comparative case series. We reviewed 40 eyes of 39 patients with underlying diagnosis of neovascular glaucoma, divided into two groups: Ahmed Glaucoma Valve (N = 20) and trabeculectomy with mitomycin C (N = 20). Surgical success was defined as 6 mm Hg ≤ intraocular pressure ≤21 mm Hg, with or without the use of glaucoma medications, with no further glaucoma surgery, and light perception or better vision. Early postoperative hypotony was defined as intraocular pressure <5 mm Hg during the first postoperative week.Results:The average follow-up was 31 months (range 6–87 months) for the Ahmed Glaucoma Valve group and 25 months (6–77 months) for the trabeculectomy group. Although the mean number of postoperative intraocular pressure-lowering medications was significantly higher in the trabeculectomy group compared with the Ahmed Glaucoma Valve group at 3 and 6 month time points, there was no statistically significant difference at any other time point. There was no statistically significant difference between both groups in postoperative visual acuity and intraocular pressure. Success was 70% and 65% at 1 year and 60% and 55% at 2 years after Ahmed Glaucoma Valve and trabeculectomy, respectively. Kaplan–Meier survival curve analysis showed no significant difference in success between the two groups (P = 0.815). Hyphema was the most common complication in both groups.Conclusion:We found similar results after trabeculectomy with mitomycin C and Ahmed Glaucoma Valve implantation in eyes with neovascular glaucoma.

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Section: Discussionmentioning

confidence: 73%

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

Shen

Salim²,

Du³

et al. 2011

OPTH

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“…Anterior segment ischemia will lead to neovascularization of the iris and the anterior chamber angle and mainly caused by retinal ischemia and hypoxia due to an ocular ischemic diseases as central (CRVO) or branch retinal vein occlusion (BRVO), proliferative diabetic retinopathy (PDR) and other causes include sickle cell retinopathy, retinal embolic diseases, chronic retinal detachment and inflammatory conditions as uveitis and vasculitis [27] . Retinal ischemia is associated with production of vascular endothelial growth factor (VEGF) which enhances retinal neovascularization, iris neovascularization and in severe cases, proliferation of fibrovascular membrane in the angle of anterior chamber which will lead to elevation of IOP and neovascular glaucoma [28] . Neovascular glaucoma (NVG) is a form of secondary glaucoma characterized by formation of new vessels and proliferation of fibrovascular tissue on iris and in the angle.…”

Section: Discussionmentioning

confidence: 99%

An observational study to assess the etiology and staging of neovascular glaucoma

Tatineni¹

2019

Int. J. Med. Ophthalmol.

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The aim of the present study was to identify the most common cause and the frequent stage of presentation in patients with neovascular glaucoma. Methods: The present study was a prospective observational study, 120 eyes of 10-patients who underwent ophthalmological examination and diagnosed as having neovascular glaucoma in one eye or both the eyes were included in the study for the period of one year. Results: The present study was conducted in 120 eyes of 100 patients out of which 90 patients had either eye involvement and 15 patients had both eyes involvement. All Patients were aged between 14-84 years with a mean of 57.59±12.6 years. Out of 100 patients, 80 (80%) were males and 20 (20%) were females. In the present study, most of the patients i.e., 60 (50%) presented in rubeosis iridis stage, 36 (30%) in angle closure stage and 24 (20%) in open angle stage. Out of 120 eyes, 78 (65%) had diabetic retinopathy in variable severity, 15 (12.5%) had inflammatory etiology, 12 (10%) had retinal vein occlusion and 12 (10%) had glaucoma (PXG and absolute glaucoma).Mean IOP in Angle closure stage is significantly higher than the mean IOP in other two stages (P = 0.000). Whereas there is no statistically significant difference between the mean IOP in rubeosis iridis stage and open angle stage (P= 0.950). Conclusion:In the present study, it was found that Proliferative diabetic retinopathy is the most common cause and rubeosis iridis is the most frequent stage of presentation in NVG.

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“…Trabeculectomy alone or Ahmed valve operations for NVG have a low success rate, probably due to excessive intra- and postoperative inflammation and bleeding from NVI 17,18…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab with or without mitomycin C trabeculectomy in the treatment of neovascular glaucoma

Marey¹,

Ellakwa²

2011

OPTH

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Purpose:To demonstrate the role of intravitreal bevacizumab in regression of iris neovascularization, and intraocular pressure (IOP) control in neovascular glaucoma.Methods:A retrospective random case series study was performed. Twenty eyes of 20 patients who presented with neovascular glaucoma were treated with intravitreal bevacizumab 2.5 mg in 0.1 mL. Retinal photocoagulation was performed for all cases as soon as possible after intravitreal injection and subscleral trabeculectomy with mitomycin C 0.4 mg/mL for 3 minutes for cases having peripheral anterior synechiae. Cases were followed up for 12 months when regression of iris neovessels, IOP control, improvement in visual acuity, and success of filtering surgery were recorded.Results:All cases showed complete regression of iris neovessels at 2 months after injection; recurrence of iris neovessels was observed in 4 cases (20%) at 4 months and in 14 cases (70%) at 8 months follow-up. The mean IOP dropped from 41.45 ± 5.89 mmHg preoperatively, to 19.3 ± 5.5 mmHg and 17.75 ± 3.74 mmHg at 6 months and 12 months postoperatively, respectively. The success rate of subscleral trabeculectomy with mitomycin C after intravitreal bevacizumab was 77.8%. Visual acuity was improved in 17 cases (85%) from preoperative 0.12 ± 0.11 to 0.26 ± 0.2 postoperative.Conclusion:Intravitreal bevacizumab has a role in regression of iris neovessels and IOP control in neovascular glaucoma cases and also in increasing the success rate of subscleral trabeculectomy with mitomycin C; however this role has a limited time and reinjection is needed to maintain this effect.

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Eyes With End-Stagelar Glaucoma

Cited by 40 publications

References 7 publications

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

An observational study to assess the etiology and staging of neovascular glaucoma

Intravitreal bevacizumab with or without mitomycin C trabeculectomy in the treatment of neovascular glaucoma

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