NEOVASCULAR GLAUCOMA: A RETROSPECTIVE EVALUATION OF MOORFIELDS EYE UNIT, BEDFORD, UK
Published 2024 - 28th ESCRS Winter Meeting
Reference: P003 | Type: Presented Poster & Poster | DOI: 10.82333/6c6q-sg82
Authors: Sam Aryee* 1 , Olivia Knutson 2 , Dipali Sutharsan 3 , Sharmila Tekriwal 3
1Bedfordshire Hospitals NHS Foundation Trust,Bedford,United Kingdom, 2School of Clinical Medicine, University of Cambridge,Cambridge,United Kingdom, 3Bedfordshire Hospitals NHS Foundation Trust,Bedford,United Kingdom;Moorfields Eye Centre,Bedford,United Kingdom
Purpose
Neovascular glaucoma (NVG) is a potentially sight-threatening secondary glaucoma characterised by anterior segment and iris neovascularisation. It is most commonly associated with proliferative diabetic retinopathy (PDR), central retinal vein occlusion (CRVO) and central retinal artery occlusion (CRAO). The main aims of this study were to identify the aetiologies of NVG in our patient cohort and compare visual acuity outcomes across intravitreal anti-VEGF, pan-retinal photocoagulation (PRP) treatment and non-treatment groups over 1 year.
Setting
This retrospective cohort study was conducted in Moorfields Eye Centre, Bedford, United Kingdom.
Methods
99 patients seen in clinic between 2009 and 2021 were included. Anterior segment imaging was reviewed for a diagnosis of NVG. Patient electronic medical records were accessed via Medisoft. Underlying aetiology, type of treatment and visual acuity at day 1 and 1 year were recorded for each patient group. We used an algorithm to convert Snellen values to LogMAR values. Wilcoxon, Mann-Whitney U and Spearman-rank tests were used for statistical analysis, where p < 0.05 was significant.
Results
The main aetiology associated with NVG in this study was Type 2 Diabetes Mellitus. 20% of the patient cohort received anti-VEGF treatment and 44% received PRP. There was a significant change in the non-treatment group (p<0.0001) but not in the anti-VEGF (p=0.22) or PRP groups (p=0.051) between day 1 and 1 year. Overall, there was a significant difference between visual acuity outcomes (p=0.0007), specifically between the non-treatment group and PRP (p=0.002) and non-treatment group and anti-VEGF group (p<0.01). There was no significant difference between the outcomes of the PRP and anti-VEGF groups (p=0.1250; rs=0.9904). Overall, the outcomes for those who received either PRP or anti-VEGF were better than the non-treatment group. When neither PRP nor anti-VEGF was given, the vast majority of patients could not perceive light after 1 year.
Conclusion
There was an overall decline in visual acuity across the cohort. However, visual outcomes tended to be better if anti-VEGF or PRP was initiated. Early initiation of anti-VEGF or PRP could improve visual outcomes, though further studies and analyses are required to ascertain which treatment had better efficacy in managing NVG.