Neovascular glaucoma

Abstract

Neovascular glaucoma (NVG) is an intractable secondary glaucoma characterized by the growth of new vessels accompanied by a fibrovascular membrane over the iris and iridocorneal angle. Majority of the cases of NVG are associated with ischemia and hypoxia of retina. The three most common predisposing conditions are ischemic central retinal vein occlusion, proliferative diabetic retinopathy, and ocular ischemic syndrome. Early identification of anterior segment neovascularization followed by prompt treatment is very important to prevent significant visual impairment. A high index of suspicion, with careful anterior segment evaluation and gonioscopy in an undilated pupil, is the key for early detection of neovascularization of iris and angle. Early stages of the disease can be managed with panretinal photocoagulation along with adjunctive use of vascular endothelial growth factor inhibitors with or without intraocular pressure lowering agents. Medical management may not be sufficient in advanced disease and may require surgical intervention.

Keywords

• Ischemic central retinal vein occlusion
• neovascular glaucoma
• panretinal photocoagulation
• trabeculectomy
• Vascular endothelial growth factor inhibitors