Reversing the Rubeotic Rampage – Current Approaches in the Management of Neovascular Glaucoma

Rodrigues, Ian; Ks, Lim

doi:10.17925/eor.2016.10.01.19

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Intravitreal injection of anti-VEGF agents in patients with NVG reportedly causes reduced vascular permeability, decreased inflammatory reaction, loss of vascular function, and endothelial cell degeneration. (6,7,8) Surgical therapy by trabeculectomy with application of antimetabolite local (Mitomycin C, 5-Fluorouracil) and Interferon alfa-2b was performed in all cases. (9,10,11,12)…”

Section: Figures No 1 2 Rubeosis Iridismentioning

confidence: 99%

The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma

Panga¹,

Stănilă²,

Stănilă

et al. 2021

Acta Medica Transilvanica

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Neovascular Glaucoma (NVG) is a severe form of glaucoma characterized by neovascularization and the proliferation of fibrovascular tissue in the anterior chamber angle. Patients with NVG generally present with elevated intraocular pressure (IOP) and may experience severe pain. Ocular surface is affected by high IOP and can lead from moderated to marked conjunctival congestion that is frequently associated with edematous cornea. The aim of the study is to show how the high IOP can affect the ocular surface of the NVG patients and how we can treat and prevent the suffering. Materials and methods: We took in the study a number of 38 eyes from 35 patients with NVG in stage 3 with angle closure glaucoma, that presented high IOP and impaired ocular surface. Results and discussions: The ocular surface was damaged in patients that presented IOP between a minimum of 38 mmHg and maximum of 89 mmHg. The symptoms that patients presented were: conjunctival congestion in particular perikeratic, epithelial and stromal corneal edema, epithelial bubble, corneal ulcerations. Treatment followed rapid drop in IOP and the restoration and protection of ocular surface. The management of neovascular eye with high IOP was medical, laser and surgical. The restoration of ocular surface was made with lubricating hyperosmotic ophthalmic solutions, regenerative and protective agents. In all cases after the treatment was performed the ocular surface was restored. Conclusions: NVG is a very difficult pathology and is very hard to manage. The uncontrolled IOP in NVG patients affect the ocular surface and leads to complications. Long-term maintenance of normal intraocular pressure is important in NVG management but also in protecting the ocular surface.

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Section: Figures No 1 2 Rubeosis Iridismentioning

confidence: 99%

The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma

Panga¹,

Stănilă²,

Stănilă

et al. 2021

Acta Medica Transilvanica

View full text Add to dashboard Cite

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“…Management of NVG is governed by two main treatment principles: reducing the neovascularization drive and controlling IOP [ 8 ]. Halting neovascularization can maintain IOP control; however, this may be temporary or inadequate [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Two-year outcomes of patients presenting to Sydney Eye Hospital with neovascular glaucoma

Kingston

Lusthaus

2023

Int Ophthalmol

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Background Neovascular glaucoma (NVG) is a sight-threatening condition that is often refractory to treatment. Current management principles are yet to be standardized due to lack of evidence. We studied the interventions used to treat NVG at Sydney Eye Hospital (SEH) and the two-year surgical outcomes. Methods We performed a retrospective audit of 67 eyes of 58 patients with NVG from January 1, 2013, to December 31, 2018. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of medications, repeat surgery, recurrent neovascularization, loss of light perception and pain were studied. Results The average age of the cohort was 59.67 years (SD 14.22). The most common etiologies were proliferative diabetic retinopathy (35 eyes; 52.2%), central retinal vein occlusion (18 eyes; 26.9%) and ocular ischemic syndrome (7 eyes; 10.4%). 70.1% of eyes (47) received vascular endothelial growth factor injections (VEGFI), 41.8% (28 eyes) received pan-retinal photocoagulation (PRP) and 37.3% (25 eyes) received both prior to or within the first week of presentation to SEH. The most common initial surgical interventions were trans-scleral cyclophotocoagulation (TSCPC) (36 eyes; 53.7%) and Baerveldt tube insertion (18 eyes; 26.9%). 62.7% of eyes (42 eyes) failed (IOP > 21 or < 6 mmHg for two consecutive reviews, further IOP-lowering surgery or loss of light perception) during follow-up. Initial TSCPC failed in 75.0% (27/36 eyes) compared with 44.4% (8/18 eyes) after Baerveldt tube insertion. Conclusion Our study reinforces the refractory nature of NVG, often despite intensive treatment and surgery. Improvements in patient outcomes may be achieved with earlier consideration of VEGFI and PRP. This study identifies the limitations of surgical interventions for NVG and highlights the need for a standardized management approach.

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Reversing the Rubeotic Rampage – Current Approaches in the Management of Neovascular Glaucoma

Cited by 2 publications

References 9 publications

The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma

The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma

Two-year outcomes of patients presenting to Sydney Eye Hospital with neovascular glaucoma

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