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Clinical management of neovascular glaucoma secondary to central retinal artery occlusion

Poster Details

First Author: D.Lopes PORTUGAL

Co Author(s):    S. Barros   S. Parreira   I. Machado   N. Campos           

Abstract Details

Purpose:

To report a relatively rare case of neovascular glaucoma (NVG) as complication of central retinal artery occlusion (CRAO).

Setting:

Hospital Garcia de Orta, Almada, Portugal

Methods:

A 74-year-old man with history of recurrent episodes of amaurosis fugax came to our emergency department with a chief complaint of sudden vision loss of the right eye that he noticed 3 days prior to admission. Ophthalmic examination revealed an afferent pupillary defect and a cherry-red spot at the macula of the same eye and he was diagnosed with CRAO. Five weeks later, the patient returned with a very painful right eye, a neovascularization of the iris (NVI) and a NVG of the same eye not responsive to medical therapy.

Results:

An anterior chamber paracentesis was performed and he received an intravitreal bevacizumab injection (IVB), followed by panretinal photocoagulation (PRP). One week after the injection, the intraocular pressure dropped from 52 to 17 mmHg and the NVI showed a complete regression, accompanied by a marked improvement of the patient�Â�´s reported pain. Since then, the intraocular pressure has been controlled with two topical anti-glaucoma medication (dorzolamide/timolol fixed combination and brimonidine) and there are no signs of neovascularization relapse.

Conclusions:

NVI and the subsequent development of NVG are serious complications found in patients with central retinal artery occlusion. Regarding to the treatment of this complication, IVB has demonstrated to be a valuable adjunct of the PRP. It should also be noted that a close follow-up of all CRAO patients for several months after obstruction, with particular attention to the development of NVI and NVG, is very important.

Financial Disclosure:

NONE

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