Neovascular glaucoma - A review

Senthil, Sirisha; Dada, Tanuj; Das, Taraprasad; Kaushik, Sushmita; Puthuran, George Varghese; Philip, Reni; Rani, Padmaja Kumari; Rao, Harsha L.; Singla, Shaveta; Vijaya, Lingam

doi:10.4103/ijo.ijo_1591_20

Cited by 73 publications

(79 citation statements)

References 76 publications

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“…At this point the eye is typically red, painful, with photophobia, a hazy cornea, and sometimes hyphaema with poor vision. 19,20 Advanced NVG usually carries a poor prognosis, often resulting in severe visual impairment. NVG is also associated with higher mortality rates.…”

Section: Diabetic Anterior Uveitismentioning

confidence: 99%

Eye problems in people with diabetes: more than just diabetic retinopathy

Kovacova

Shotliff

2022

Practical Diabetes

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While diabetic retinopathy and maculopathy are leading causes of premature visual loss in people with diabetes, other retinal and non-retinal pathology should be considered in the differential diagnosis. These include issues with both eye movement and vision, and can be split into: those which are extraocular, including orbital cellulitis and cranial nerve palsies; those in the anterior segment, including dry eyes, visual disturbances, superficial eye infections, anterior uveitis, cataracts and neovascularisation glaucoma; and those in the posterior segment of the eye, including endophthalmitis, diabetic papillopathy and ischaemic optic neuropathy. This article reviews each of these areas in respect to a person with diabetes, with the aim to highlight some of these conditions to health care staff who manage patients with diabetes. Awareness of conditions other than diabetic retinopathy should help with timely referral and treatment to limit visual disability, which can have a significant impact on daily living.

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Section: Diabetic Anterior Uveitismentioning

confidence: 99%

Eye problems in people with diabetes: more than just diabetic retinopathy

Kovacova

Shotliff

2022

Practical Diabetes

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“…In contrast, the neovessels are chaotically arranged, lie superficial and often cross the scleral spur. As a result, the iridocorneal angle closes in a zipper pattern [ 2 , 5 , 13 , 40 - 43 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…In cases of iris and/ or iridocorneal angle neovascularization, panretinal photocoagulation and anti-VEGF therapy will be started immediately. Until the neovascular glaucoma is established, we could cope with the neovascularization, and treatment can delay its onset [ 2 , 26 , 27 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

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A review of neovascular glaucoma. Etiopathogenesis and treatment.

Dumbrăveanu

Cușnir

Bobescu

2021

rjo

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Neovascular glaucoma (NVG) is a type of secondary glaucoma, refractory to treatment, often incurable, with very poor visual prognosis. It is characterized by the appearance of new vessels over the iris and iridocorneal angle and frequently associates the presence of a fibrovascular membrane which limits the aqueous humor outflow from the anterior chamber. The most common causes of NVG are: central retinal vein occlusion, proliferative diabetic retinopathy, and ocular ischemic syndrome. Once the gonioscopy developed as a part of clinical examination, it became possible to visualize the new vessels of the anterior segment of the eye in early stages and to understand the mechanisms of increased intraocular pressure (IOP), including narrowing and closing of the iridocorneal angle. Also, the modern imaging techniques, such as optical coherence tomography angiography and fluorescein angiography became indispensable for the clinician. Thus, an early diagnosis, followed by starting an appropriate therapy: panretinal photocoagulation or administration of anti-VEGF drugs, with or without hypotensive ocular therapy, allows the preservation of visual functions for patient’s better quality of life. However, one or more surgeries will often be required, especially in the advanced stages of the disease, which do not respond to drug therapy. Managing the NVG we should aim to: 1) reduce ocular ischemia and treat its underlying cause, 2) reduce elevated IOP, once installed and 3) control the inflammatory process. Anyway, the best treatment is prevention, so we must be very attentive at patients with risk factors for developing the NVG. Abbreviations: NVG = neovascular glaucoma, ICA = iridocorneal angle, IOP = intraocular pressure, TM = trabecular meshwork, AH = aqueous humor, AC = anterior chamber, PRP = panretinal photocoagulation, VEGF = vascular endothelial growing factor, Anti-VEGF = anti- vascular endothelial growing factor, PAS = peripheral anterior synechiae, CRVO = central retinal vein occlusion, PDR = proliferative diabetic retinopathy, DR = diabetic retinopathy, OIS = ocular ischemic syndrome, CRAO = central retinal artery occlusion, ROP = retinopathy of prematurity, FEVR = familial exudative vitreoretinopathy, PVR = proliferative vitreoretinopathy, MMPs = matrix metalloproteinases, VEGFR = vascular endothelial growing factor receptor, PDGF = platelet-derived growth factor, PIGF = placental growth factor, NRP = neuropilins, HIF = hypoxia-inducible factor, SDF1 = stromal cell-derived factor 1, DDL4 = delta like ligand 4, NICD = Notch intracellular domain, TIMMPs = tissue inhibitors of matrix metalloproteinases, ANGPT = angiopoietin, Tie 2 = tyrosine-protein kinase receptor for angiopoietins, IGF-1 = insulin-like growth factor 1, RPE = retinal pigment epithelium, IL = interleukin, TNF = tumor necrosis factor, bFGF = basic fibroblast growth factor, TGF = transforming growth factor, HGF = hepatocyte growth factor, TNFR 2 = tumor necrosis factor receptor 2, OIR = oxygen induced retinopathy, NVI =...

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“…Although the prevalence of NVG is generally low, it contributes to significant vision loss and morbidity. The rate of NVG in the population is as low as 0.12% [3]. In hospital studies, the percentage of eyes with NVG among secondary glaucoma was 9 to 17.4% [4].…”

Section: Introductionmentioning

confidence: 99%

Role of Anti-VEGF (Bevacizumab) in Management of Neovascular Glaucoma: A Review

Alharfy

Albalawi

Alzahrani

et al. 2021

JPRI

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Neovascular glaucoma (NVG) is an aggressive type of glaucoma, which often results in poor visual outcomes. Antivascular endothelial growth factor is frequently used for various conditions in which VEGF release is induced in response to retinal ischemia. Bevacizumab is a humanized anti-VEGF monoclonal IgG1 antibody. The potential of antivascular endothelial growth factor (anti-VEGF) agents to modify the disease course of neovascular glaucoma (NVG) was recognized shortly after their use in the treatment of age-related macular degeneration was reported. These medications were noted to induce rapid regression of the anterior segment neovascularization that characterizes NVG. Several studies as well as extensive clinical experience have demonstrated a rapid regression of anterior segment neovascularization following the injection of anti-VEGF agents. This review aims to summarize current evidences regarding effectiveness of Bevacizumab in management of neovascular glaucoma.

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Neovascular glaucoma - A review

Cited by 73 publications

References 76 publications

Eye problems in people with diabetes: more than just diabetic retinopathy

Eye problems in people with diabetes: more than just diabetic retinopathy

A review of neovascular glaucoma. Etiopathogenesis and treatment.

Role of Anti-VEGF (Bevacizumab) in Management of Neovascular Glaucoma: A Review

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