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TitleAudit- Neovascular glaucoma at Sydney Eye Hospital
PurposeTo determine the interventions used to treat neovascular glaucoma (NVG) at Sydney Eye Hospital (SEH) and study the 2 year surgical outcomes.
MethodsSEH's electronic medical records and ‘ICD 10-AM' were searched. 67 eyes of 58 patients who presented to SEH with NVG from 1st of January 2013 to the 31st of December 2018 and fulfilled selection criteria, were found. Outcomes included; intraocular pressure (IOP), visual acuity (BCVA), medications used and further surgical interventions.
ResultsThe study population had an average age of 59.67 years (SD 14.22). The most common aetiologies were proliferative diabetic retinopathy (52.2%), central retinal vein occlusion (26.9%) and ocular ischaemic syndrome (10.4%). 86.6% of patients received intravitreal bevacizumab injections and 71.6% received pan-retinal photocoagulation pre-operatively or intra-operatively when the operation was within the first week of initial review. The most common initial surgical interventions were transscleral cyclophotocoagulation (50.7%) and Baerveldt tube insertion (23.9%). Median BCVA at 24 months was 2.30 log units (IR 2.00) with median IOP of 16 (IR 17). 64.2% of eyes failed during follow-up (IOP >= 21 or <= 6 for two consecutive reviews, where further IOP lowering operations were required or loss of light perception occurred). 76.5% failed in the TSCPC group and 43.7% in the BVT group.
ConclusionImprovements in outcomes may be achieved with earlier and more frequent consideration of vascular endothelial growth factor inhibitors and pan-retinal photocoagulation. This study identifies the limitations of surgical interventions and highlights the need for a standardised approach.
Conflict of interestNo
Authors 1
Initials of first name(s)EJ
DepartmentSydney Eye Hospital
Authors 2
Last nameLusthaus
Initials of first name(s)JA
DepartmentGlaucoma Sydney Eye Hospital