Audit- Neovascular glaucoma at Sydney Eye Hospital
Purpose
To determine the interventions used to treat neovascular glaucoma (NVG) at Sydney Eye Hospital (SEH) and study the 2 year surgical outcomes.
Methods
SEH's electronic medical records and ‘ICD 10-AM' were searched. 67 eyes of 58 patients who presented to SEH with NVG from 1st of January 2013 to the 31st of December 2018 and fulfilled selection criteria, were found. Outcomes included; intraocular pressure (IOP), visual acuity (BCVA), medications used and further surgical interventions.
Results
The study population had an average age of 59.67 years (SD 14.22). The most common aetiologies were proliferative diabetic retinopathy (52.2%), central retinal vein occlusion (26.9%) and ocular ischaemic syndrome (10.4%). 86.6% of patients received intravitreal bevacizumab injections and 71.6% received pan-retinal photocoagulation pre-operatively or intra-operatively when the operation was within the first week of initial review. The most common initial surgical interventions were transscleral cyclophotocoagulation (50.7%) and Baerveldt tube insertion (23.9%). Median BCVA at 24 months was 2.30 log units (IR 2.00) with median IOP of 16 (IR 17). 64.2% of eyes failed during follow-up (IOP >= 21 or <= 6 for two consecutive reviews, where further IOP lowering operations were required or loss of light perception occurred). 76.5% failed in the TSCPC group and 43.7% in the BVT group.
Conclusion
Improvements in outcomes may be achieved with earlier and more frequent consideration of vascular endothelial growth factor inhibitors and pan-retinal photocoagulation. This study identifies the limitations of surgical interventions and highlights the need for a standardised approach.
Conflict of interest
No
Authors 1
Last name
KINGSTON
Initials of first name(s)
EJ
Department
Sydney Eye Hospital
City
Sydney
Country
Australia
Authors 2
Last name
Lusthaus
Initials of first name(s)
JA
Department
Glaucoma Sydney Eye Hospital
City
Sydney
Country
Australia
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