Abstract
Purpose :
To determine the patient characteristics that predict worse clinical outcomes in the setting of neovascular glaucoma (NVG) secondary to proliferative diabetic retinopathy (PDR), central retinal vein occlusion (CRVO), central retinal artery occlusion (CRAO), or ocular ischemic syndrome (OIS) treated with intravitreal anti-VEGF injections.
Methods :
The study is a retrospective case series of patients with NVG treated with intravitreal bevacizumab or ranibizumab. Markers predicting progression of NVG were assessed. The main outcome variables were worsening of visual acuity (VA) at 3 months from time of diagnosis and uncontrolled intraocular pressure (IOP) requiring glaucoma surgery. Patients were excluded due to prior panretinal photocoagulation, vitrectomy, or glaucoma surgery. All statistical analyses were conducted using SPSS, Version 26 (SPSS, Inc., Chicago, IL, USA). Multivariate model generated using forward step-wise variable selection method of logistic regression.
Results :
At the time of diagnosis, none of the 31 eyes of 31 patients had received glaucoma surgery in the affected eye, and median VA was count fingers (CF). Of the 31 cases, causes of NVG were 12 from CRVO (39%), 8 from CRAO (26%), 8 from PDR (26%), 2 from both CRVO and PDR (6%), and 1 from ocular ischemic syndrome (3%). Multivariate analysis revealed that HM vision or worse at time of diagnosis (p=0.043) and female sex (p=0.027) were independent factors for receiving glaucoma surgery in the affected eye (OR: 10.64 and 12.82, respectively.) Age <65, greater than 4 prescription glaucoma drops per day, and IOP > 30 were not significant predictors. No factors were significant predictors for worsening VA at 3 months.
Conclusions :
Worse baseline VA and female gender were correlated with an increased risk of requiring glaucoma surgery in the setting of NVG treated with intravitreal anti-VEGF agents. However, worse VA at 3 months was not correlated with age, number of glaucoma drops per day, increased IOP, gender, or VA at time of diagnosis.
This is a 2020 ARVO Annual Meeting abstract.