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R. Narayanan, A. B. Majji, S. Jalali, R. Reddy, A. Mathai, N. Hussain, G. S. Sekhar; Outcomes of Neovascular Glaucoma in a Tertiary Care Center in South India. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5206.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the outcomes of neovascular glaucoma in a tertiary eye hospital in India.
Retrospective chart review of patients with ICD 9.0 code for neovascular glaucoma who presented between July 2006 and June 2007. Patients who had neovascularization of the iris and baseline intraocular pressure above 21 mm Hg were included. Patients with presenting vision worse than counting fingers and less than 3 months follow-up were excluded. The primary outcome measure was the best corrected visual acuity. Secondary outcome measure was the intraocular pressure.
Ten eyes of 9 patients matching the inclusion criteria were included in the study. Eight patients were male and one patient was female, with a median age of 48 years (range 37-71 years). Diabetes melitus was present in 6 patients (median duration 16 years), and hypertension was seen in 6 cases (median duration 3.5 years). Diabetes and hypertension co-existed in 4 cases. The median duration of symptoms was 2.5 months, and the right eye and left eye were affected in 5 eyes each. The cause of neovascular glaucoma was central retinal vein occlusion (6 eyes) and proliferative diabetic retinopathy (4 eyes). The median follow-up was 6.5 months (range 3-11 months). The median visual acuity at baseline was 20/120 and at the final visit was 20/60. The visual acuity remained stable in 5 eyes, improved in 3 eyes, and worsened in 2 eyes. The mean intraocular pressure at baseline was 33.8 mm Hg and at the last follow-up was 18.2 mm Hg. Two patients were on anti-glaucoma medication to control the intraocualr pressure. Nine eyes underwent panretinal photocoagulation, one had pars plana vitrectomy with endolaser. Four eyes received intravitreal bevacizumab, and 2 patients underwent anterior retinal cryopexy. None of the patients underwent filtering surgery to control the intraocular pressure.
Aggressive management of patients with neovascular glaucoma using combination with complete retinal ablation can help stabilize or improve the vision in patients with neovascular glaucoma.
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