Abstract
Purpose: To determine the prevalence, identify the causes and outline the management options available at our center for the treatment of neovascular glaucoma. Setting: The study was carried out in the department of ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. Methods: The case records of all patients who were managed in the department of ophthalmology from January 2013 to December 2017 for neovascular glaucoma were retrieved. Data collected included, age, sex, causes of neovascular glaucoma, presenting visual acuity, treatment options and outcomes, systemic and ocular comorbidities. Results were analysed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software. Results: Thirty-two eyes (32) of twenty-eight patients were studied. The hospital prevalence of neovascular glaucoma was 0.3%. There were 4 cases of bilateral neovascular glaucoma (NVG). Retinal vein occlusion 17 (53%) was the commonest cause of NVG followed by proliferative diabetic retinopathy 13 (41%). Uveitis was seen in only 2 (6%) eyes. The commonest form of intervention used was a combination of medical therapy and anti VEGFs. Fifty percent (50%) of the study population had a lowering of their intraocular pressures within the normal limits post treatment and this was statistically significant (p = 0.000). However, only 10% had an improvement in their visual acuity after treatment. Conclusions: Neovascular glaucoma is a potential blinding condition with challenges in control of intraocular pressures and preservation of vision. Early detection and attention to aetiological factors with timely institution of the appropriate mode of treatment may help in preserving vision.
Highlights
Retinal vein occlusion 17 (53%) was the commonest cause of neovascular glaucoma (NVG) followed by proliferative diabetic retinopathy 13 (41%)
Neovascular glaucoma (NVG) is a severe form of secondary glaucoma that occurs with blockage of aqueous outflow through the trabecular meshwork due to development of new vessels on the iris (NVI) and iridocorneal angle (NVA) as a result of anterior segment ischaemia
This results in very elevated levels of intraocular pressure (IOP) that eventually culminates in optic atrophy if timely management is not instituted
Summary
Neovascular glaucoma (NVG) is a severe form of secondary glaucoma that occurs with blockage of aqueous outflow through the trabecular meshwork due to development of new vessels on the iris (NVI) and iridocorneal angle (NVA) as a result of anterior segment ischaemia This results in very elevated levels of intraocular pressure (IOP) that eventually culminates in optic atrophy if timely management is not instituted. Posterior segment ischeamia usually arises from complications of ocular disorders, such as retinal venous and arterial occlusions, proliferative diabetic retinopathy, carotid artery obstructive disease and uveitis [4] [5] [6] [7] These conditions lead to a hypoxic retina causing ischaemia with release of angiogenic factors which eventually migrate to the anterior segment. This study will add to the body of knowledge in this regard
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