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Rajiv Khandekar, Abdullah Al-Bahlal, Tariq Alzahim, Deepak P Edward, Igor Kozak; Epidemiology of Neovascular Glaucoma (NVG) from 2002 to 1012 at King Khaled Eye Specialist Hospital, Saudi Arabia.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3698.
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© ARVO (1962-2015); The Authors (2016-present)
Neovascular glaucoma (NVG) is an ischemic ocular complication with a potential of causing severe visual impairment and blindness. We present the incidence and determinants of NVG between 2002 and 2012 at a tertiary eye hospital in Saudi Arabia.
In this ophthalmic charts review, NVG cases diagnosed by vitreo-retina and glaucoma units at the King Khaled Eye Specialist Hospital in Riyadh were included. The annual incidence rate was calculated. The determinants included gender, age, systemic comorbidities, lens status, type of NVI and visual acuity on presentation. Additionally, the impact of anti-angiogenic therapy on incidence on NVG was studied. We used univariate analysis for statistical analysis.
We studied 597 eyes with NVG. The overall annual incidence of NVG was 6.6/10,000. It markedly declined from 13/10,000 in 2008 to 0.1/10,000 in 2012 (figure: 1). Of note was the introduction of intravitreal injection of Bevacizumab in 2008 in Saudi Arabia. Males had significantly higher risk of NVG than females (OR = 2.2). Diabetes and hypertension were associated with NVG in 88 % and 42.7% of cases, respectively. In 377(72%) of diabetic patients, the glycemic control was poor (HbA1C >7 %). Visual acuity on presentation was 20/20 to 20/40 in 14 (2%), 20/50 to 20/200 in 79 (13%) and <20/200 to 20/400 in 456 (76%) and <20/400 in 45 (7%) eyes. Intraocular pressure was higher than 30mmHg in 438 (73%) eyes. A total 340 (57%) eyes were phakic. The cup-to-disc (CD) ratio was greater than 0.8 in 86 (14%) eyes. During early period (2002 to 2007) and later period (2008 to 2012), the glaucoma presentation; CD ratio (χ 2 = 4, p =0.09) and type of angle (p = 0.8) was not different. The contralateral eye showed NVG at presentation (OR = 0.8, p = 0.3) or follow up (OR = 1.0, p = 0.9) in both periods was not different.
NVG was more common in males and associated with poor glycemic control. There was risk of the contralateral eye developing glaucoma. Most patients had poor visual acuity at presentation. The incidence of NVG decreased following the introduction of anti-angiogenic therapy in 2008.
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