Neovascular Glaucoma in a Nigerian African population

Abstract

Objective: To determine the ocular and systemic factors associated with neovascular glaucoma (NVG) in an African population. Design: Hospital based cross sectional study. Setting: Eye clinic, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria. Subjects: Sixty one consecutive patients with clinical diagnosis of NVG seen between January 1995 and December 1999 had a complete ocular evaluation. Results: Among the 61 subjects studied with an identifiable aetiological factor presumably causing neovascular glaucoma, 82% had associated posterior segment diseases producing ischaemia. These were retinal venous obstruction (78.7%), retinal arterial occlusion (1.6%). Those with no identifiable vaso-occlusive disease had couching (11.5%), aphakia with vitreous loss (3.3%) and chronic uveitis (1.6%). Systemic arterial hypertension was present in 62.3% while diabetes mellitus was present in only 8.3% of the subjects studied. Chronic uveitis and penetrating eye injury were infrequently diagnosed. Chronic open angle glaucoma was present in the other eye of 37.7% of subjects. Neovascular glaucoma was unilateral in 95.1% of subjects. 84.4% of affected eyes were blind on presentation. Males outnumbered females among subjects with NVG above 40 years, while females outnumbered males in the subjects below 40 years of age. Eyes of that were couched constitute a significant proportion of subjects with neovascular glaucoma. Conclusion: Medical conditions such as systemic hypertension, diabetes and ocular conditions like retinal vein, retinal artery occlusion, couching and glaucoma were associated with NVG. Most of these ocular and systemic associations should be identified early and treated to prevent neovascular glaucoma in the other eye of the subject.

Prevalence, Causes and Management of Neovascular Glaucoma: A 5-Year Review

“…This was similar to local and international studies done on NVG. [5] [15] [16]. The similar range of etiological factors such as proliferative diabetic retinopathy, RVO and uveitis reported in these studies could account for this.…”

Pattern of diabetic retinopathy in Kano, Nigeria

“…A study in Ibadan Nigeria reported that 8.3% of those with NVG had diabetic eye disease. [29] There is a huge time limit between onset of diabetes mellitus and development of retinopathy. Therefore, there is avenue for screening patients, making an early diagnosis and instituting prompt intervention whenever there is the need to do so.…”

Couching in Nigeria: Prevalence, Risk Factors and Visual Acuity Outcomes

“…[4][5] A population based study undertaken in a rural area of Mali in 1996 matched individuals who had undergone ICCE cataract surgery without intraocular lens (IOL) with those who had been couched. 6 A total of 82 individuals out of the total population of 99,800 had been couched.…”