Neovascular glaucoma in patients with central retinal vein o
Central retinal vein occlusion (CRVO) is common vascular retinopathy that may cause substantial visual loss. Ocular neovascularization is the most feared complication. It most commonly occurs in the anterior part of the eye causing neovascularization of the iris (NVI) and neovascularization of the angle (NVA), the latter often causing neovascular glaucoma (NVG), with elevated intraocular pressure and glaucomatous damage to the optic nerve. A study was conducted to investigate the characteristics and treatment patterns of patients developing a neovascular event (NE) in the anterior chamber secondary to central retinal vein occlusion (CRVO) in an ordinary clinical setting.

Of 243 eligible patients, 72 either presented with or developed NE during the followup. In these 72 patients, 23 eyes already had evidence of NE at baseline. Twenty-eight eyes developed NE after discontinuation of intravitreal therapy for macular edema (ME). In this subgroup, the NE occurred 15.6 ± 13.8 months after the baseline visit and 4.1 ± 2.6 months after the last injection. Final best-corrected visual acuity was 8.6 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the group of patients presenting with NE compared to 8.1 ETDRS letters in the group that developed NE later on. Of the patients presenting with intraocular pressure (IOP) below 30 mmHg, 3/29 needed subsequent cyclodiode laser therapy compared to 35/43 patients with a baseline IOP above 30 mmHg.

In a clinical setting, many patients show evidence of NE already at the first visit. A substantial part of patients develops NE a long time after the presentation, commonly a few months after discontinuation of intravitreal therapy for ME. The visual prognosis is similar for patients presenting with NE and patients developing NE during follow-up. A high baseline IOP predicts the need for subsequent pressure-lowering procedures.