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1 General aspects (0)   1.1 Epidemiology (6)   1.2 Population genetics (0)   1.3 Pathogenesis (0)   1.4 Quality of life (12)   1.5 Glaucomas as cause of blindness (6)   1.6 Prevention and screening (15) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (3)   2.2 Cornea (18)   2.3 Sclera (3)   2.4 Anterior chamber angle (4)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (9)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (1)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (1)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (5)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (6)   2.9 Ciliary body (0)   2.10 Lens (1)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (26)   2.14 Optic disc (21)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (3)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (0)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (20)   3.5 Molecular biology incl. 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(5) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (6)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (0)     9.1.1 Congenital glaucoma, Buphthalmos (15)     9.1.2 Juvenile glaucoma (15)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (1)     9.1.4 Other (0)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (5)     9.2.2 Other risk factors for glaucoma (6)     9.2.3 Open angle glaucoma with elevated IOP (4)     9.2.4 Normal pressure glaucoma (9)   9.3 Primary angle closure glaucomas (0)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (7)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (11)     9.3.3 Plateau iris syndrome (1)     9.3.4 Primary angle closure suspect (1)     9.3.5 Primary angle closure (2)     9.3.10 Other (0)   9.4 Glaucomas associated with other ocular and systemic 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Filtering surgery (0)     12.8.1 Without tube implant (21)     12.8.2 With tube implant or other drainage devices (72)     12.8.3 Non-perforating (9)     12.8.4 Using laser (1)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (11)     12.8.11 Complications, endophthalmitis (16)   12.9 Trabeculotomy, goniotomy (25)   12.10 Cyclodestruction (9)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (7)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (14)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (1)   12.20 Other (1) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (3)   13.2 Outcome (0)     13.2.1 IOP (1)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (1)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (3) 15 Miscellaneous (47)

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Abstract #94700 Published in IGR 22-2

Early Surgical Intervention for Neovascular Glaucoma in a Patient with Diabetes

Husain KA; Alaali H; Alderazi H
Cureus 2021; 13: e15420

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Neovascular glaucoma (NVG) is a cause of blindness in patients with proliferative diabetic retinopathy (PDR) and remains a clinical challenge. It results from vascular endothelial growth factor (VEGF) expression, which occurs in cases of severe retinal ischemia. Early detection and immediate comprehensive management, including early surgical intervention, are essential to maintain good intraocular pressure (IOP) control and achieve the best visual outcome, as presented in this case. A 42-year-old male patient with bilateral NVG secondary to PDR received complex management with early Ahmed valve implantation surgery, followed by pan-retinal photocoagulation (PRP) and intravitreal bevacizumab injection. After 22 months of treatment and follow-up, we could achieve the best visual outcome for the patient. Early surgical intervention for uncontrolled NVG with a glaucoma filtration device combined with intravitreal anti-VEGF injections and adequate PRP showed beneficial effects in the IOP control with rapid resolution of iris neovascularization, thus achieving the best visual function.

Ophthalmology Department, Salmaniya Medical Complex, Manama, BHR.

Full article

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Classification:

9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)

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