Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico

Abstract

Aim To describe the demographic characteristics, ocular comorbidities, and clinical outcomes of patients with neovascular glaucoma (NVG) and to determine the number of patients who returned for a follow-up eye examination.Materials and methods We examined the clinical data of patients with NVG, who attended a glaucoma clinic between July 2010 and November 2014. We collected information on the demographic characteristics of the patients to include the level of education, ocular comorbidities, NVG stage, visual acuity, glaucoma medications, intraocular pressure (IOP), and the number of patients who had a follow-up ocular examination at month 1, 3, 6, and 12.Results Data from 350 patients (473 eyes) with NVG were collected. We found 91% of the cohort had proliferative diabetic retinopathy (PDR). We found blindness in both or one eye in 14% and 31% of the cohort respectively. Low vision was found in both or one eye in 14% and 32% of the eyes respectively. By 6 months follow-up, only 32% of the patients were seen at our clinic and by 12 months follow-up, this number decreased to 15%. Around 60% of the patients were on no IOP lowering drugs at the first visit. We found 53% of the cohort had an incomplete elementary school education.Conclusion The results suggest that advanced NVG is a significant ocular problem for patients referred to our clinic with just over half of the patients presenting as blind. We also found that several socioeconomic factors that had an important role in the development of PDR and NVG, specifically, educational status.Clinical significance We described the characteristics of a large cohort of patients with very advanced NVG, reflecting the fact that the strict control of the underlying disease must be the main goal of the Mexican national health system.How to cite this article Lazcano-Gomez G, Soohoo JR, Lynch A, Bonell LN, Martinez K, Turati M, González-Salinas R, Jimenez-Roman J, Kahook MY. Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico. J Curr Glaucoma Pract 2017;11(2):48-51.

Intravitreal anti-vascular endothelial growth factor injection combined with panretinal photocoagulation for neovascular glaucoma in Indonesian patients with diabetes mellitus: a prospective study

“…5,6 Prolonged ischemia in the retina may cause severe complications, including neovascular glaucoma (NVG), which is one of the most difficult types of glaucoma to treat. [7][8][9][10] In NVG, levels of VEGF in the aqueous humor are increased, whereas under normal circumstances (the normal range is: mean [SD] = 59.5 (24.6) pg/ml), VEGF in the aqueous humor is known to regulate microvascular endothelial permeability and the permeability of Schlemm's canal endothelium, essential for conventional aqueous humor outflow.¹¹…”

Clinical profile and outcomes of neovascular glaucoma in the era of anti-vascular endothelial growth factor

“…[ 1 2 3 ] We found 75–90% eyes to be blind at presentation in this cohort, with little improvement in vision despite aggressive interventions, which is higher than in previously reported studies. [ 2 3 8 9 10 ]…”

“…[ 4 5 6 7 ] Population studies and hospital-based studies report a prevalence of 0.5–9% visual morbidity across different parts of the world. [ 2 8 9 10 ] This results from ocular ischemia triggering neovascularization of the iris (NVI), angle (NVA), or the posterior segment (neovascularization elsewhere, NVE) with consequent obstruction of outflow channels in the eye. Raised intraocular pressure (IOP) and refractory glaucoma in NVG often require multiple interventions and a multidisciplinary approach.…”

“…[ 2 3 ] Earlier studies have reported the demographic profile of NVG caused by various etiologies with scanty reference to the stage of the disease or the rates of blindness in different disease stages. [ 8 9 10 ] Gomez et al . [ 9 ] reported 14% blindness in 350 NVG Mexican patients, with half of the eyes being blind at presentation.…”

“…[ 8 9 10 ] Gomez et al . [ 9 ] reported 14% blindness in 350 NVG Mexican patients, with half of the eyes being blind at presentation. This study stratified NVG eyes into three stages while including eyes without raised IOP.…”