For patients who have already suffered an acute case of central retinal vein occlusion (CRVO), the presence of hypertension, low visual acuity or relative afferent pupillary defect can all foreshadow neovascular glaucoma (NVG) development, according to a study published in the American Journal of Ophthalmology. These patients, the authors suggest, may be at greater risk for neovascularization and could benefit from early intervention with intravitreal anti-vascular endothelial growth factor (VEGF) therapy, which can delay NVG onsent.
To identify these risk factors, the authors reviewed the records of Bascom Palmer Eye Institute patients with CRVO between 2013 and 2017. They looked at patients with recent CRVO onset (i.e., within three months), no anterior segment neovascularization and those who never received anti-VEGF injections before. Thirteen percent of the patients who met the inclusion criteria developed NVG. The mean adjusted time to NVG diagnosis from the onset of CRVO-related symptoms was 212 days. The records were evaluated for other factors too, including the patients’ age, body mass index, history of glaucoma or diabetes and central retinal thickness. None of these factors were significantly associated with NVG.
Although early treatment with anti-VEGF injections can slow the progression of NVG, it cannot prevent it altogether.
|Rong A, Swaminathan S, Vanner E, Parrish R. Predictors of neovascular glaucoma in central retinal vein occlusion. Am J Ophthalmol. March 9, 2019. [Epub ahead of print].