Abstract
Purpose :
There is limited literature on mortality risk after a Neovascular glaucoma (NVG) diagnosis. We aim to characterize the impact of NVG and its underlying etiology on mortality. We hypothesize NVG associated with proliferative diabetic retinopathy (PDR) and central retinal artery occlusion (CRAO) will have a higher mortality risk than NVG from central retinal vein occlusion (CRVO) or other eye-specific conditions
Methods :
A retrospective chart review was performed on patients with NVG diagnosis seen at our tertiary care center from 2015-2016 (n=220). Patients were excluded if they had ocular cancers (n=6) or unspecified diagnosis (n=4). Underlying etiology was classified as PDR, CRVO, CRAO, ocular ischemic syndrome (OIS) or “other”. CDC National Death Index was used to designate if subjects were alive on Dec 31, 2021 and determine primary cause of death. NVG onset data (within one month) was available for 132 subjects who were included in the Kaplan Meier (KM) survival analysis
Results :
Of 210 patients with an NVG diagnosis in 2015-2016, 32% (n=68) were deceased by Dec 31, 2021. PDR and CRVO were the commonest diagnoses (demographics are in Table 1). PDR subjects were statistically younger compared to CRVO subjects (p<0.05). Deceased PDR subjects (n=38) were also statistically younger than deceased CRVO subjects (n=18) (age 63±14 vs 84 ± 9 years, p<0.05). There were differences (p=0.07) in primary cause of death between CRVO (33% respiratory, 17% cardiac, 6% cerebrovascular, 44% other) and PDR (11% respiratory, 39% cardiac, 16% cerebrovascular and 34% others).
Mean survival time (months) using KM analysis was 154 ± 15 for all subjects (n=132) and 57 ±16 for CRAO (n=9), 117 ± 16 for OIS (n=6), 125 ± 12 for CRVO (n=37), 135 ± 18 for other (n=7) and 166 ± 19 for PDR (n=73). There was no difference in mean survival time (months) between black and white races. Linear regression models demonstrated age, rather than race or ocular diagnosis had the largest impact on mortality
Conclusions :
NVG diagnosis has a significant impact on mortality with mean survival of 154 months after diagnosis. Although mean survival time was similar in PDR and CRVO, subjects with PDR were more than a decade younger on average than subjects with CRVO and more likely to die of cardiac or cerebrovascular causes
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.