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Neovascular glaucoma in patients with central retinal vein occlusion: A real‐life study in the anti‐VEGF era
Author(s) -
Casselholm de Salles Manuel,
Lindberg Charlotte,
Epstein David
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14500
Subject(s) - medicine , discontinuation , visual acuity , central retinal vein occlusion , intraocular pressure , diabetic retinopathy , ophthalmology , glaucoma , retrospective cohort study , retinal vein , surgery , diabetes mellitus , macular edema , endocrinology
Purpose 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. Methods In this retrospective real‐life study, data from 243 eyes presenting with CRVO during 2012–2013 were collected. Maximum follow‐up was 5 years. All patients that developed NE were included in the analysis. Results Of 243 eligible patients, 72 (30%) either presented with or developed NE during the follow‐up. In these 72 patients, 23 (32%) eyes already had evidence of NE at baseline. Twenty‐eight eyes (39%) developed NE after discontinuation of intravitreal therapy for macular oedema (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 (10%) needed subsequent cyclodiode laser therapy compared to 35/43 (81%) patients with a baseline IOP above 30 mmHg (p < 0.001). Conclusions 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 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.