Anti-VEGF treatment is the key strategy for neovascular glaucoma management in the short term.

Abstract

BACKGROUND:

To present a comprehensive approach for the management of patients with neovascular glaucoma (NVG) aiming to preserve visual function and complement pan-retinal photocoagulation (PRP) by anti-vascular endothelial growth factor (anti-VEGF) treatment and anti-glaucoma surgery.

METHODS:

This study includes a prospective, interventional case series. A process flow chart for NVG management was designed. Totally 50 patients (51 eyes) with NVG were included. Of these, 43 patients (44 eyes) completed the treatment process. Patients were divided into central retinal vein occlusion (CRVO) and proliferative diabetic retinopathy (PDR) groups according to their original diagnosis. Intraocular pressure (IOP), visual function, and the status of iris and angle neovascularization were recorded before and after treatment.

RESULTS:

Patients were followed up for 6-30 months (mean 12.2 months). The IOP of all 44 patients was effectively controlled and was significantly less after treatment (16.68 ± 4.69 mmHg) than before treatment (42.59 ± 9.44 mmHg, P < 0.05). Thirty-nine eyes displayed controlled IOP (≤21 mmHg) after treatment. Visual acuity improved, to some extent, in 32 eyes (72.9 %), and 12 eyes (27.3 %) had a visual acuity better than 0.1. There was no significant difference in IOP between the PDR and CRVO groups at the end of follow-up (P = 0.8657), but the visual acuity in the PDR group was much better than that in the CRVO group (P = 0.0079).

CONCLUSIONS:

A comprehensive therapy for NVG can effectively control IOP and preserve visual function in patients by anti-VEGF injection and anti-glaucoma surgery.

• Authors: Yaoyao Sun, Yong Liang, Peng Zhou, Huijuan Wu, Xianru Hou, Zeqin Ren, Xiaoxin Li, Mingwei Zhao
• Journal: BMC ophthalmology (BMC Ophthalmol) Vol. 16 Issue 1 Pg. 150 (Aug 30 2016) ISSN: 1471-2415 [Electronic] England
• PMID: 27576739 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Adolescent
• Adult
• Aged
• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Combined Modality Therapy
• Diabetic Retinopathy (drug therapy)
• Female
• Glaucoma, Neovascular (drug therapy, physiopathology, surgery)
• Humans
• Intraocular Pressure (physiology)
• Light Coagulation (methods)
• Male
• Middle Aged
• Prospective Studies
• Retinal Vein Occlusion (drug therapy)
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)
• Young Adult