Abstract
Purpose :
To study the occurrence of neovascular glaucoma in patients with severe diabetic retinopathy who were treated solely with anti-VEGF therapy and their treatment afterwards
Methods :
We reviewed the outcome of eyes with severe diabetic retinopathy who were treated with anti-VEGFs alone. The patients were in follow-up care for two years, undergoing monthly structural OCTs and biyearly color fundus photography and fluorescein angiography
Results :
Forty-five eyes from seventy patients who were treated with anti-VEGFs alone were followed for two years. Seven of these eyes developed neovascular glaucoma over the two-year follow-up. Two of the seven eyes had been treated with ranibizumab; two with bevacizumab; and three with aflibercept
All eyes with neovascular glaucoma were then treated with both panretinal photocoagulation and additional injections of the same anti-VEGF that was initially used. The neovascular glaucoma progression stabilized then. The presenting visual acuity varied between 20/100 to 20/400 prior to the treatment. All patients had worse acuity after treatment (20/400 to count fingers).
Conclusions :
Neovascular glaucoma developed in eyes with diabetic retinopathy who are treated with anti VEGFs alone despite close follow-up. The condition responds well to treatment with panretinal ablation and additional anti VEGF injections, but despite the rigorous treatment, the visual outcome is poor
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.