SUMMARY
Purpose:
To investigate: 1. The causes of neovascular glaucoma (NVG) in our population. 2. Possible factors related to the prognosis of NVG. 3. The results of the treatment of NVG.
Methods:
Thirty-eight patients with a diagnosis of NVG, from September 1996 to March 1997, were retrospectively evaluated at the Glaucoma Service of the University of Campinas.
Results:
The most important cause of NVG was proliferative diabetic retinopathy, which was found in 18 patients (47.4%), whereas central retinal vein occlusion was observed in 14 patients (36.8%). The visual acuity at presentation was significantly related to the final visual acuity (p = 0.01). However, initial intraocular pressure and the extension of peripheral anterior sinechiae were not associated with the final visual acuity (p > O. 05). Among the 38 patients, 8 (21.1%) underwent a surgical procedure, which led to a significant decrease of intraocular pressure from 39.75 ± 10.99 mmHg to 21.88 ± 12.14 mmHg (p = 0.01). Five patients (13.1%) achieved IOP control following retinal ablation associated with treatment with drugs. The remaining 25 patients (65.8%) presented with very low visual acuities (light perception or less), which did not justify a surgical procedure. At the end of follow-up, 71.1% of the patients had visual acuity worse or equal to light perception.
Conclusion:
NVG was found to be refractory to treatment and showed an unfavorable visual prognosis. In the attempt to avoid the unfavorable visual outcome of patients with NVG, a flow chart was proposed to guide the treatment of such patients.
Keywords:
Neovascular glaucoma; Photocoagulation; Gonioscopy; Intraocular pressure