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

Glaucoma

Abstract

Introduction: Neovascular glaucoma (NVG) also called 100 day or congestive glaucoma, is a severe form of secondary glaucoma that occurs with blockage of aqueous outflow due to development of new vessels on the iris (NVI) and iridocorneal angle (NVA) as a result of anterior segment ischaemia.^1,2 It was first described by Weiss et al in 1963.³ Anterior segment neovascularisation is believed to result from posterior segment ischaemia arising from ocular disorders such as retinal venous occlusion(RVO) and arterial occlusions, proliferative diabetic retinopathy (PDR), carotid artery obstructive disease and uveitis.^4,5,6,7 Glaucoma develops through secondary open angle or secondary closed angle mechanisms.8 Patients usually present with complaints of redness, photophobia, pain and loss of vision.¹ Other findings include, elevated IOP, conjunctival congestion, corneal edema, hyphaema and posterior segment ischaemia.¹ Anti- VEGFs are now being used with other modalities of treatment such as transscleral cyclophotocoagulation(TSCPC), incisional glaucoma surgery and medical therapy in the management of NVG^9,10 . Successful visual outcome is reduced once NVG is established,  timely detection of the risk factors and their control are key in preventing visual loss.

Methods: Case records of patients attending the retina clinic of the University of Port Harcourt Teaching Hospital between January 2015 to December 2017 were reviewed. Parameters evaluated included patients’ demographics, visual acuity, cause of neovascular glaucoma and treatment modalities.