Clinical Profile and Management of Neovascular Glaucoma in North India
Purpose: To report the etiology, clinical features, treatment and outcomes of neovascular glaucoma (NVG) in a tertiary care ophthalmic center. Background: NVG is a devastating ocular disease often leading to loss of vision. The current standard of care includes retinal phtocoagulation and control of...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-10-01
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| Series: | Delhi Journal of Ophthalmology |
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| Online Access: | https://journals.lww.com/10.4103/dljo.dljo_56_23 |
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| author | Ketaki Rajurkar Suneeta Dubey Monica Gandhi Prachi Gurav Julie Pegu |
| author_facet | Ketaki Rajurkar Suneeta Dubey Monica Gandhi Prachi Gurav Julie Pegu |
| author_sort | Ketaki Rajurkar |
| collection | DOAJ |
| description | Purpose:
To report the etiology, clinical features, treatment and outcomes of neovascular glaucoma (NVG) in a tertiary care ophthalmic center.
Background:
NVG is a devastating ocular disease often leading to loss of vision. The current standard of care includes retinal phtocoagulation and control of increased intraocular pressure with medical and surgical therapy like trabeculectomy, Ahmed Glaucoma Valve (AGV) and Trans scleral cyclophotocoagulation (TSCPC) with studies comparing them showing varied results. We compared these treatment modalities to find out which is better for IOP control.
Methods:
Retrospective file review.
Results:
230 eyes of 217 patients with NVG were studied. Mean age of the population was 56.99 ± 13.8 years. Venous occlusion (37.4%) was the commonest cause of NVG followed by diabetic retinopathy (35.2%). All the patients were managed medically to begin with. Ninety one patients underwent surgical management. Pan retinal photocoagulation was done for 68.75% patients. Anti- vascular endothelial growth factor (VEGF) was given intravitreally for 56.25% patients prior to surgery. Thirty six patients underwent trabeculectomy with Mitomycin C (MMC), eleven patients underwent AGV implantation and thirty three underwent TSCPC. Best corrected visual acuity at baseline was 2.24 ± 0.99. Final visual acuity was 2.67 ± 1.1. Best corrected visual acuity (BCVA) was either stable or improved from baseline in 46.25% patients and deteriorated in 53.5%. All three modalities were equally effective in reducing IOP from baseline (p = 0.00) and there was no statistically significant difference between them taking IOP into consideration as success criteria (p = 0.60). Hyphaema was the commonest complication (22.5%).
Conclusion:
Venous occlusion was the commonest cause of NVG in our setup. All three modalities of treatment, AGV, trabeculectomy with MMC and TSCPC are effective in controlling the disease process. The visual prognosis however remains poor despite surgical treatment due to late presentation and fast progression. |
| format | Article |
| id | doaj-art-99938d7fbf5e4ca88c92d3e98e1567e6 |
| institution | Kabale University |
| issn | 0972-0200 2454-2784 |
| language | English |
| publishDate | 2022-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Delhi Journal of Ophthalmology |
| spelling | doaj-art-99938d7fbf5e4ca88c92d3e98e1567e62025-08-20T03:52:28ZengWolters Kluwer Medknow PublicationsDelhi Journal of Ophthalmology0972-02002454-27842022-10-01326192310.4103/dljo.dljo_56_23Clinical Profile and Management of Neovascular Glaucoma in North IndiaKetaki RajurkarSuneeta DubeyMonica GandhiPrachi GuravJulie PeguPurpose: To report the etiology, clinical features, treatment and outcomes of neovascular glaucoma (NVG) in a tertiary care ophthalmic center. Background: NVG is a devastating ocular disease often leading to loss of vision. The current standard of care includes retinal phtocoagulation and control of increased intraocular pressure with medical and surgical therapy like trabeculectomy, Ahmed Glaucoma Valve (AGV) and Trans scleral cyclophotocoagulation (TSCPC) with studies comparing them showing varied results. We compared these treatment modalities to find out which is better for IOP control. Methods: Retrospective file review. Results: 230 eyes of 217 patients with NVG were studied. Mean age of the population was 56.99 ± 13.8 years. Venous occlusion (37.4%) was the commonest cause of NVG followed by diabetic retinopathy (35.2%). All the patients were managed medically to begin with. Ninety one patients underwent surgical management. Pan retinal photocoagulation was done for 68.75% patients. Anti- vascular endothelial growth factor (VEGF) was given intravitreally for 56.25% patients prior to surgery. Thirty six patients underwent trabeculectomy with Mitomycin C (MMC), eleven patients underwent AGV implantation and thirty three underwent TSCPC. Best corrected visual acuity at baseline was 2.24 ± 0.99. Final visual acuity was 2.67 ± 1.1. Best corrected visual acuity (BCVA) was either stable or improved from baseline in 46.25% patients and deteriorated in 53.5%. All three modalities were equally effective in reducing IOP from baseline (p = 0.00) and there was no statistically significant difference between them taking IOP into consideration as success criteria (p = 0.60). Hyphaema was the commonest complication (22.5%). Conclusion: Venous occlusion was the commonest cause of NVG in our setup. All three modalities of treatment, AGV, trabeculectomy with MMC and TSCPC are effective in controlling the disease process. The visual prognosis however remains poor despite surgical treatment due to late presentation and fast progression.https://journals.lww.com/10.4103/dljo.dljo_56_23neovascular glaucomaetiologytreatment |
| spellingShingle | Ketaki Rajurkar Suneeta Dubey Monica Gandhi Prachi Gurav Julie Pegu Clinical Profile and Management of Neovascular Glaucoma in North India Delhi Journal of Ophthalmology neovascular glaucoma etiology treatment |
| title | Clinical Profile and Management of Neovascular Glaucoma in North India |
| title_full | Clinical Profile and Management of Neovascular Glaucoma in North India |
| title_fullStr | Clinical Profile and Management of Neovascular Glaucoma in North India |
| title_full_unstemmed | Clinical Profile and Management of Neovascular Glaucoma in North India |
| title_short | Clinical Profile and Management of Neovascular Glaucoma in North India |
| title_sort | clinical profile and management of neovascular glaucoma in north india |
| topic | neovascular glaucoma etiology treatment |
| url | https://journals.lww.com/10.4103/dljo.dljo_56_23 |
| work_keys_str_mv | AT ketakirajurkar clinicalprofileandmanagementofneovascularglaucomainnorthindia AT suneetadubey clinicalprofileandmanagementofneovascularglaucomainnorthindia AT monicagandhi clinicalprofileandmanagementofneovascularglaucomainnorthindia AT prachigurav clinicalprofileandmanagementofneovascularglaucomainnorthindia AT juliepegu clinicalprofileandmanagementofneovascularglaucomainnorthindia |