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Núria Artells de Jorge, Sara Sánchez Tabernero, Sara Crespo Millas, Carolina Meneses Galicia, Maria Isabel López Gálvez, Lucía Manzanas Leal, José Ramón Juberías Sánchez; High cardiovascular mortality in patients with diabetic neovascular glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1901.
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Neovascular glaucoma (NVG) is a potential complication of end stage proliferative diabetic retinopathy (DR). It is a severe form of secondary glaucoma that often leads to blindness and sometimes intractable pain. Diabetic patients with retinopathy have a higher risk of suffering a cardiovascular event or dying than retinopathy-free diabetic subjects. The presence of an advanced form of DR or secondary visual impairment have been shown to further increase the chance of cardiovascular death. In this retrospective observational study, we attempt to determine if the presence of NVG could be a predictor of cardiovascular disease or death for diabetic patients.
This study included patients diagnosed with diabetic NVG from 2006 to 2016 at Hospital Clínico Universitario de Valladolid (Spain) followed and treated by the same experienced glaucoma consultant. Extracted data included the clinical characteristics of the patients, glycated haemoglobin levels, visual acuity (VA) and intraocular pressure (IOP). Cardiovascular events (including myocardial infarction, other ischemic heart disease and stroke) and deaths were recorded.
30 eyes from 23 patients were included and followed for a mean of 4.48 years (SD=2.82 years). One patient had had a cardiovascular event before the observation period. Five patients suffered a systemic event after NVG diagnosis. Four patients died, three of them from cardiovascular events and one from unknown causes. No statistically significant difference could be established between patients with low VA (defined as finger count or worse, or ≥ 1.7logMAR), poor IOP control or bad metabolic control and mortality or cardiovascular event (p> 0.05). However and although differences were not statistically significant, four of five patients who had a cardiovascular event and all the four patients who died had poor VA at the time of NVG diagnosis.
Advanced NVG could be an indicator of higher mortality risk for diabetic patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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