Assessment of the effectiveness of Intravitreal anti-vascular endothelial growth factor on lowering intraocular pressure in early Neovascular glaucoma

Abstract

Neovascular glaucoma (NVG) is a serious refractory form of secondary glaucoma with poor prognosis characterized by iris and iridocorneal neovascularization and increase intraocular pressure. The underlying pathogenesis in most cases is posterior segment ischemia such as proliferative diabetic retinopathy, central retinal vein occlusion, ocular ischemic syndrome. Neovascularization in the eye occurs due to an imbalance between pro-angiogenic factors as vascular endothelial growth factor VEGF and other anti-angiogenic factors as pigment-epithelium- derived factor. Therefore, anti –VEGF antibody may serve as a useful adjunctive to the therapy of NVG via its antiangiogenic anti fibroblastic properties. It lead to regression of both iris and angle neovascularization, and controlling intraocular pressureThe management of NVG is approached by first treating the underlying condition responsible for the neovascular stimulus. This can be achieved by panretinal photocoagulation and intravitreal anti VEGF. Secondarily Controlling the elevated IOP which may lead to progressive optic neuropathy if untreated either medically or surgically