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David G Miller, Rohit Chandra, Lauren Fill, Chase W Miller, Jenny Gan, Angela Giltner, Scott D Pendergast; Neovascular Glaucoma Presenting Characteristics in a Referral-based Setting. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1974.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the presenting characteristics of neovascular glaucoma (NVG) patients in a referral practice setting.
IRB approval was obtained to perform a retrospective chart review over 7 years (June 2011-June 2018) by identifying charts with a diagnostic code search in the electronic medical record (EMR) system in a single retinal specialty practice. De-identified patient records were then tabulated for data on presentation that included sex, age, eye, best corrected visual acuity (VA), intraocular pressure (IOP), hyphema, number of glaucoma medications, anterior chamber (AC) tap, anti-VEGF use, and underlying cause of NVG. VA was converted to LogMar units for calculations and reporting. Statistical analysis was used to generate mean, range, standard deviation (SD) for age, VA, and IOP.
A total of 308 patients met inclusion criteria. There were 164 males (53.2%), and 144 females (46.8%) (mean age 73.09 years, range 26-104, SD ± 15.0 years). There were 164 right eyes and 144 left eyes (total = 308). Presenting mean VA was LogMar 1.39 (Snellen equivalent 20/480) (range 20/20 to no light perception, SD ± 0.79). Presenting mean IOP was 33.8 mmHg (range 8-79, SD ± 14.95). Hyphema was present in 119 (38.6%). Glaucoma medications were already being used by 227 (73.7%) of patients on presentation. The mean number of glaucoma medications was 1.81 ± 1.43, with 121/308 (39.3%) receiving anterior chamber paracentesis. Anti-VEGF injection was administered to 209/308 (67.9%) eyes on presentation, with the following agents used: bevacizumab 174/209 (83.3%), ranibizumab 23/209 (11%), and aflibercept 12/209 (5.7%). NVG etiologies were proliferative diabetic retinopathy (PDR) 133/308 (43.2%), central retinal vein occlusion (CRVO) 121/308 (39.3%), branch retinal vein occlusion (BRVO) 15/308 (4.8%), neovascular age-related macular degeneration (nARMD) 13/308 (4.2%), central retinal artery occlusion (CRAO) 10/308 (3.3%), uveitis 2/308 (0.7%), ocular ischemic syndrome (OIS) 2/308 (0.7%), and retinal detachment (RD) 2/308 (0.7%).
NVG presents to a referral practice with poor VA and elevated IOP, often leading to interventions such as AC tap and anti-VEGF injections. The underlying diagnosis of NVG was most commonly PDR or CRVO, accounting for 82.5% of cases. Further analysis of interventions and outcomes based on underlying diagnosis may be of interest.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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