Clinical profile and outcomes of neovascular glaucoma in the era of anti-vascular endothelial growth factor

• Published in: Indian journal of ophthalmology Vol. 69; no. 10; pp. 2728 - 2733
• Main Authors: Malgi, Vishwesh Sirish, Gawas, Lisika, Iyer, Archana Suresh, Rao, Aparna
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.10.2021; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Acuity; anti-vegf; Bevacizumab; Blindness; Care and treatment; Developing countries; Diagnosis; Electronic medical records; Eye; Glaucoma; Glaucoma, Neovascular - diagnosis; Glaucoma, Neovascular - drug therapy; Glaucoma, Neovascular - epidemiology; Health aspects; Humans; Intraocular Pressure; LDCs; Measurement; Morbidity; neovascular glaucoma; Patients; rubeotic glaucoma; secondary glaucoma; Special Focus, Glaucoma, Original; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Visual impairment; India; Anti-VEGF; rubeotic glaucoma; secondary glaucoma; blindness; neovascular glaucoma
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_528_21

To report the clinical profile and visual impairment in various stages of neovascular glaucoma (NVG) at a tertiary eye center in East India. The electronic medical records of the hospital database of patients with neovascular glaucoma seen between 2013 and 2020 were reviewed. Gonioscopic details were used to stratify patients into nonspecified NVG (Group 1), open-angle NVG (Group 2), and closed-angle NVG (Group 3). The clinical profile, angle features, cause of NVG, systemic associations, visual impairment, and blindness (defined as logarithm of the minimum angle of resolution, LogMar >1.3 at baseline and at final follow-up), and outcomes of medical/surgical interventions were compared between the three groups. Of 846 eyes of 810 patients with NVG (Group 1, n = 564 eyes, Group 2, n = 61 eyes, and Group 3, n = 220 eyes), at baseline, the blindness rates in Groups 3 and 2 were 90 and 75%, respectively. The time from a previous intervention to the onset of NVG ranged from 3 to 5 months, while the median duration of NVG was about 4-4.5 months (0.03-120 months). Multivariate regression identified a longer duration of NVG as the only variable associated with poor final visual acuity. Visual morbidity by NVG remains as high as 75-90% in developing countries, even with the availability of anti-VEGFs and after improved management/investigative at all stages.