Clinical characteristics and interventions in neovascular glaucoma cases: a study from the glaucoma care clinic at Cairo University Hospitals

Abstract

Aim The aim of this study was to report the epidemiology, clinical characteristics, causes, management, and outcome of neovascular glaucoma (NVG) in a tertiary facility in Egypt (Glaucoma Care Clinic at Cairo University Hospitals). Patients and methods The demographic and clinical data of 251 eyes diagnosed with NVG were retrospectively studied. The antiglaucoma medications and interventions used for management were reviewed with analysis of the outcome in the form of success rate, final visual acuity (VA) and intraocular pressure (IOP). Complete success was defined as an IOP between 6 and 21\u2009mm Hg without topical or systemic glaucoma medications with preservation of presenting VA. Results NVG was diagnosed in 7.9% of all glaucoma patients in our clinic. The prevalence was more in men (58.8%), and the mean age was 56.5±11 years. Diabetic retinopathy was the most common cause for NVG (61.4%), followed by central retinal vein occlusion (21.4%). The presenting VA was light perception (LP) or less in 45% of the eyes. Diode laser cyclophotocoagulation was the most common treatment modality used (57%), followed by antiglaucoma medications only in 28% and finally surgery in 15% of the patients. Complete success in the diode group was achieved in 73.43% of the cases compared with 68.42% in the surgery group, with no statistically significant difference (P=0.522). The effect of an intravitreal injection of antivascular endothelial growth factor on the final IOP was significant (P=0.024). Conclusions NVG has a high prevalence in our glaucoma patients. The patients presented very late, with nearly half of the patients having VA of LP or less. This led to decreased resort to surgical intervention. Diode laser cyclophotocoagulation was the main treatment modality used, with significant control of the IOP.