Clinical experience in the management of neovascular glaucoma

Tung Mei Kuang, Catherine Jui Ling Liu, Ching Kuang Chou, Wen-Ming Hsu

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background. Neovascular glaucoma (NVG) is a devastating ocular disease with poor prognosis. The ideal surgical procedure has yet to be determined. In this study, the clinical course and visual outcome of NVG and their fellow eyes were investigated and the most appropriate management was also evaluated. Methods. The study was conducted retrospectively consisting of NVG in-patients of Taipei Veterans General Hospital who were under the care of the same glaucoma specialist between January, 1998 and September, 2000. All patients had a minimal follow-up period of 6 months. Results. The total number of patients enrolled was 35 (number of eyes enrolled was 35) with mean age of 66.4 ± 12.3 years. The underlying cause was diabetes mellitus in 29 patients and central retinal vein occlusion in 6 patients. Twelve (34.3%) eyes had initial intraocular pressure (IOP) of over 60 mmHg. Only 1 (2.9%) eye had initial visual acuity better than 6/60. Four lesion eyes were able to receive panretinal photocoagulation whereas 31 eyes received panretinal cryotherapy. For IOP reducing procedures, 15 eyes received trabeculectomy, and 16 received Diode trans-scleral cyclophotocoagulation (TSCP). At the final visit, 20 eyes (trabeculectomy group: 11 and Diode TSCP group: 9) were able to maintain an IOP≤21 mmHg. Of these eyes, 15 (trabeculectomy group: 8 and Diode TSCP group: 7) were able to maintain or improve their vision. Of the remaining 4 eyes, 2 had cyclocryotherapy and 2 had trabeculectomy followed by Diode TSCP. IOP were controlled in these 4 eyes but none were able to maintain stable vision. Among the 34 fellow eyes with stable IOP, 32 were able to maintain stable vision. Conclusions. Trabeculectomy and Diode TSCP provided no statistically significant difference in IOP control (p = 0.32) and visual outcome (p = 0.59) in our patient group. More randomized, prospective trials are needed to define the most effective treatment for NVG.

Original languageEnglish
Pages (from-to)131-135
Number of pages5
JournalJournal of the Chinese Medical Association
Volume67
Issue number3
Publication statusPublished - Mar 1 2004
Externally publishedYes

Keywords

  • Cyclocryotherapy
  • Diode transcleral cyclophotocoagulation
  • Neovascular glaucoma
  • Panretinal cryotherapy
  • Panretinal photocoagulation
  • Trabeculectomy

ASJC Scopus subject areas

  • Medicine(all)

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