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Neovascular Glaucoma

Presentation

Case report of a 48 years old female patient which presented at the emergency room with painful red left eye. At presentation best corrected left eye visual acuity was 1/10, intraocular pressure was 36 mm Hg. [ncbi.nlm.nih.gov]

Entire Body System

  • Cat Scratch

    Review of the clinical, laboratory, photographic, and angiographic records of a patient with cat scratch disease associated with central retinal artery and vein occlusion, neovascular glaucoma, and severe vision loss. [ncbi.nlm.nih.gov]

Skin

  • Xanthoma

    Generalized eruptive xanthomas were found on the back and extremities. Extreme dyslipidemia (serum cholesterol 1311 mg/dl and triglycerides 6356 mg/dl) and diabetes mellitus (fasting plasma glucose 325 mg/dl and HbA1 c 12.1%) were first diagnosed. [ncbi.nlm.nih.gov]

Eyes

  • Chemosis

    Early posttreatment complications included hyphema, fibrin's exudation, chemosis. Cyclocryotherapy is usefull and accessible method for control of intensive pain in neovascular glaucoma. [ncbi.nlm.nih.gov]

    Clinical presentation include: conjunctival hyperemia, chemosis and/or serosanguineous exudates, pseudomembranous conjunctivitis, bilateral episcleritis, superior limbic keratoconjunctivitis or cicatricial conjunctivitis. [zdoc.site]

Neurologic

  • Headache

    Neovascular glaucoma symptoms range from minor vision disturbances to debilitating headaches and total vision loss. A visual field test can detect central and peripheral vision problems caused by glaucoma. [visual-field-software.com]

    Stage 1 2 3 Rubsosis iridis Secondary open-angle glaucoma Secondary angle closure glaucoma Symptoms None to mild, redness, pain, photophobia Redness, pain, photophobia, mild headache Acute severe pain, headache, photophobia, nausea or vomitting Pupils [reviewofoptometry.com]

    PRESENTATION  SYMPTOMS - Sudden pain - Headache ,vomiting - Redness - Watering - Defective vision - Photophobia 8. [slideshare.net]

    Angle-closure glaucoma, on the other hand, is sudden onset and characterized by a painful, red, and hard eye in combination with frontal headache, blurry vision, and halos appearing around lights. [amboss.com]

Workup

CRVO, diabetic retinopathy, CAOD, and CRAO require systemic workup and appropriate intervention to prevent further complications. [emedicine.medscape.com]

General treatment Diabetes patients require a thorough systemic workup and appropriate intervention to prevent further complications. Tight glycemic control is vital as the onset of NVG in diabetics is associated with glucose control. [oatext.com]

Microbiology

  • Bartonella Henselae

    To report a case of Bartonella henselae infection. Observational case report. [ncbi.nlm.nih.gov]

Treatment

Prevention of NVG is always preferable to treatment of the consequences of NVG. [ncbi.nlm.nih.gov]

Thus, intravitreal bevacizumab serves as an effective temporizing treatment, but is not a replacement for close monitoring and definitive treatment of NVG. [journalretinavitreous.biomedcentral.com]

Osmotic agents may be used to clear the cornea to improve visualization for treatment or diagnosis. [eyewiki.aao.org]

Prognosis

At the final follow-up, the mean logMAR visual acuity was 3.13 ± 1.24, showing a poor prognosis regardless of whether NVG occurred. CONCLUSIONS: Overall, the prognosis for ocular ischemic syndrome is very poor. [ncbi.nlm.nih.gov]

Generally, NVG carries a very guarded prognosis. Prognosis is highly dependent on diagnosis and treatment of NVG early in its course. The later it is diagnosed the worse the visual prognosis. [theeyeclinicsurgicenter.com]

Prognosis Generally, NVG carries a very guarded prognosis. Prognosis is highly dependent on the following 2 factors: prevention and treatment of NVG early in its course and the underlying disease process. [emedicine.medscape.com]

Etiology Iris neovascularization at initial presentation is considered an indicator of poor visual prognosis. [reviewofoptometry.com]

Etiology

Etiology is reported for all 310 eyes of 284 patients managed in the department. [ncbi.nlm.nih.gov]

Retinal Vascular Occlusive Disease (RVOD) RVOD was the second most common etiologic factor associated with NVG. [dx.doi.org]

Epidemiology

We compared the trends of epidemiological variables in EP and LP [Table 3]. [ijo.in]

Keywords: intraocular pressure • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • clinical (human) or epidemiologic studies: outcomes/complications © 2010, The Association for Research in Vision and [iovs.arvojournals.org]

References: [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Neovascular glaucoma: epidemiology and prognostic factors. Proposal of a flow chart to guide the treatment. Arq. Bras. Oftalmol. [online]. 1998, vol.61, n.5, pp.519-524. ISSN 0004-2749. http://dx.doi.org/10.5935/0004-2749.19980022. [scielo.br]

An epidemiological study of diabetes mellitus on the Island of Falster, Denmark. Acta Ophthalmol (Copenh) 1983;61:662-672. Kahook M, Shuman J: Chandler and Grant's Glaucoma. Thorofare, Slack, 2013, pp 309-317. [karger.com]

Pathophysiology

Mediators that induce new vessel formation such as the vascular endothelial growth factor-A seem to play a key role in the pathophysiology of this condition. [ncbi.nlm.nih.gov]

Overview Pathophysiology Basic physiological principles References: [4] [5] Open-angle glaucoma Etiology Primary cause unclear Risk factors Age > 40 years Increased IOP African descent Diabetes mellitus Familial predisposition Myopia Steroid use Pathophysiology [amboss.com]

PATHOPHYSIOLOGY The underlying pathophysiology of NVG begins with oxygen deprivation, which leads to angiogenesis and neovascularization (NV). [glaucomatoday.com]

The objective of this review is to discuss its etiology, pathophysiology, clinical features and management. [djo.org.in]

Prevention

We report 4 cases using intracameral air injection for the prevention of the tube obstruction of AGV by blood clot. [ncbi.nlm.nih.gov]

Prevention Prevention should be focused on preventing the most common underlying causes of neovascular glaucoma, including retinal vein blockage and diabetic retinopathy. [brightfocus.org]

Antiangiogenic drugs may be used to promote the regression of neovascularization, but generally do not prevent laser photocoagulation and surgical intervention. [fernandez-vega.com]

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