Demographic, Socioeconomic, and Clinical Factors Associated with Severe Vision Loss in Patients with Neovascular Glaucoma

Abstract

Purpose To investigate the association between demographic, socioeconomic, and clinical factors and severe vision loss in patients with neovascular glaucoma (NVG). Patients and Methods A retrospective chart review of patients referred to the University of Virginia (UVA), diagnosed with NVG, and treated for NVG between January 2010 and December 2020 was performed. Patients were grouped according to vision outcomes after 1 year of treatment: mild – moderate vision loss (best corrected visual acuity [BCVA] > light perception [LP]) and severe vision loss (BCVA ≤ LP). The associations between patient characteristics and BCVA were also examined. Results Of the 89 patients (99 eyes), those with progression to severe vision loss presented with higher intraocular pressure (IOP) (p < 0.001) and lower visual acuity (p = 0.003) on average. However, there was no difference in IOP between the vision loss groups after one year of treatment. Univariate analysis showed a moderate association between a history of type 2 diabetes mellitus (T2DM) and severe vision loss (p = 0.033). Increasing age was associated with an increased likelihood of progression to severe vision loss (odds ratio [OR] 1.074, p = 0.008). Females were more likely to exhibit severe vision loss (OR 3.281, p = 0.036). Patients with Medicare (OR 0.098, p = 0.005) or private insurance (OR 0.110, p = 0.006) were less likely to progress to severe vision loss than those without insurance. Conclusion Progression of vision loss in patients with NVG may be influenced by the stage of disease at diagnosis, age, sex, T2DM, and insurance status.