Prognostic Factor Analysis of Intraocular Pressure with Neovascular Glaucoma

Abstract

Purpose. To perform multivariate analysis for identifying independent predictors of elevated intraocular pressure (IOP) with neovascular glaucoma (NVG), including antivascular endothelial growth factor (VEGF) intravitreal injections. Methods. We retrospectively reviewed 142 NVG patients (181 eyes) with ischemic retinal diseases [proliferative diabetic retinopathy (PDR) in 134 eyes, retinal vein occlusion (RVO) in 29, and ocular ischemic syndrome in 18]. We analyzed age, gender, initial/final LogMAR VA, initial/final IOP, extent of iris and/or angle neovascularization, treatments, preexisting complications, concurrent medications, and follow-up duration. Results. The mean follow-up duration was 23.8 ± 18.8 months. At the final follow-up, 125 (72.3%) eyes had IOP ≤ 21 mmHg. NVG patients with RVO had a higher degree of angle closure and higher IOP. NVG with PDR had better IOP and LogMAR VA. Angle closure had the greatest impact on final IOP. Greater than 90% of patients treated with trabeculectomy with mitomycin C (LEC) had persistent declines in IOP (≤21 mmHg). Stand-alone and combination anti-VEGF therapies were not associated with improved long-term prognosis of IOP. Conclusions. Angle closure was found to have the greatest effect on NVG-IOP prognosis. When target IOP values are not obtained after adequate PRP with or without anti-VEGF, early LEC may improve the prognosis of IOP.

Effect of Preoperative Intravitreal Bevacizumab on the Surgical Outcome of Neovascular Glaucoma at Different Stages

“…In univariate analysis, PRP, PAS, and IVB were putative factors for all the eyes, while the PRP and PAS were the related factors in a multivariate model with borderline significances. Nakano et al [ 8 ] retrospectively reviewed 181 eyes of patients with NVG and found that angle closure had the greatest effect on an NVG-IOP prognosis, with a HR of 3.059, which is in line with our results. Olmos et al [ 5 ] who reviewed 163 eyes of patients with NVG with a mean follow-up of 12 months reported that PRP was the most important prognostic factor, with its long-lasting antiangiogenic effect.…”

What is the impact of intravitreal injection of conbercept on neovascular glaucoma patients: a prospective, interventional case series study

“…In our study, IOP at the last visit was significantly lower than baseline IOP (P < 0.05), which is consistent with the results of Silva et al and Lin Zhaobin et al [29,36]. Satoko et al showed that high IOP and poor angle function at baseline in NVG patients were associated with uncontrolled IOP postoperatively [37]. In our study, baseline IOP in 19 eyes was higher than 60 mmHg, producing exudated depigmentation, which caused serious postoperative pigment membrane reaction such that trabecular meshwork and filtration path were obstructed, and the angles of these patients were completely closed.…”

What is the impact of intravitreal injection of conbercept on neovascular glaucoma patients: a prospective, interventional case series study

“…In our study, IOP was significantly lower at the last visit than at baseline ( P < 0.05), consistent with the results of Silva et al and Lin Zhaobin et al [29, 36]. Satoko et al showed that in NVG patients, high IOP and poor angle function at baseline were associated with uncontrolled IOP postoperatively [37]. In our study, the baseline IOP was higher than 60 mmHg in 19 eyes, in which exudated depigmentation occurred, causing serious postoperative pigment membrane reactions.…”