Changing epidemiology of neovascular glaucoma from 2002 to 2012 at King Khaled Eye Specialist Hospital, Saudi Arabia

Abstract

Purpose:The aim is to present the incidence and determinants of neovascular glaucoma (NVG) in Saudi Arabia.Methods:A retrospective review of NVG cases (2002–2012) was included to estimate the incidence. The determinants included gender, age, comorbidities, lens status, type of NVG, and visual acuity on presentation. The impact of antiangiogenic therapy on NVG incidence was studied.Results:We studied 597 eyes with NVG. The incidence was 6.6/10,000. It declined from 13/10,000 in 2008–0.1/10,000 in 2012 (P < 0.001). The decline in 2008 coincided with the introduction of intravitreal injection bevacizumab in Saudi Arabia. Males had a significantly higher NVG risk (odds ratio [OR] = 2.2). Diabetes and hypertension were associated with NVG in 88% and 42.7% of cases, respectively. In 377 (72%) diabetic patients, the glycemic control was poor (HbA1C >7%). Visual acuity was 20/20–20/40 in 14 (2%), 20/50–20/200 in 79 (13%), 20/200–20/400 in 456 (76%), and <20/400 in 45 (7%) eyes. Intraocular pressure was higher than 30 mmHg in 438 (73%) eyes. The cup-to-disc (CD) ratio was >0.8 in 86 (14%) eyes. During the early period (2002–2007) and later period (2008–2012), CD ratio (χ2 = 4, P = 0.09) and anterior chamber angle (P = 0.8) were not different. The presence of NVG in contralateral eye (OR = 0.8, P = 0.3) in both periods was similar.Conclusions:NVG was associated with diabetes in a very large proportion of patients. It was significantly associated with males, and with poor glycemic control and poor vision at presentation. The incidence of NVG declined after the introduction of intravitreal bevacizumab.

Epidemiological Characteristics of Inpatients Undergoing Surgery for Glaucoma at Tianjin Eye Hospital from 2013 to 2017

“…The reason for the sex difference in the SG group (male : female = 1 : 0.55) might be due to traumatic glaucoma, which is related to male violence. NVG, as the major type of SG, is mainly caused by diabetic retinopathy [ 29 ]. Indeed, the proportion of diabetes in the SG group was higher in our study.…”

Management and visual outcome of neovascular glaucoma in diabetes mellitus patients

“…2 In a study conducted in Saudi Arabia, an increase in incidence of NVG in males as compared to females was found which was statistically significant. 3 NVG can be caused by multiple ocular and systemic conditions. The most common among them are diabetic retinopathy (DR) (33%), followed by ischemic CRVO (33%) and ocular ischemic syndrome (13%).…”

Early Surgical Intervention for Neovascular Glaucoma in a Patient with Diabetes

“…Neovascular glaucoma (NVG) is a secondary glaucoma that causes vision loss and is characterized by the development of neovascularization of the iris (NVI), elevated intraocular pressure (IOP), and, in many instances, poor visual prognosis [ 1 ]. NVG results from severe ocular ischemia and is commonly associated with posterior segment conditions such as proliferative diabetic retinopathy (PDR), central retinal vein occlusion (CRVO), central retinal artery occlusion, and ocular ischemic syndrome [ 2 ].…”

“…NVG results from severe ocular ischemia and is commonly associated with posterior segment conditions such as proliferative diabetic retinopathy (PDR), central retinal vein occlusion (CRVO), central retinal artery occlusion, and ocular ischemic syndrome [ 2 ]. The estimated incidence of NVG in patients with diabetes is approximately 6.6/10,000 individuals, which accounts for 5% of blindness cases in these patients [ 1 ]. The term NVG was first used by Pagenstecher in 1871 and was used to describe hemorrhagic, thrombotic, congestive, rubeotic, and diabetic hemorrhagic glaucomas [ 3 , 4 ].…”