Risk factors for uncontrolled glaucoma in NVG treated with anti-VEGF injections identified

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Amongst patients with neovascular glaucoma (NVG) treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapy, there are several baseline characteristics that may help retina specialists predict a higher risk of uncontrolled glaucoma, according to a study.

In this retrospective cohort study at a retina subspecialty practice, 301 eyes of patients with newly diagnosed NVG not previously treated with glaucoma surgery, were treated with intravitreal anti-VEGF injections.

During the course of the study period (September 8, 2011 to May 8, 2020), 31% of eyes required glaucoma surgery and 20% progressed to no light perception vision.

The following characteristics at the time of diagnosis were risk factors for glaucoma surgery or blindness regardless of anti-VEGF therapy:

-IOP >35 mmHg
-2 or more topical glaucoma medications
-Worse than 20/100 vision
-Proliferative diabetic retinopathy
-Eye pain/discomfort
-New patient status

Significant in a subgroup analysis of patients without media opacity, panretinal photocoagulation was found to no be statistically effective.

Massenzio E, Xu D, Abishek R, et al. Risk Factors for Surgery or Blindness in Neovascular Glaucoma Eyes Treated with Anti-VEGF Injections by a Retina Specialist. Retina. 2023;doi: 10.1097/IAE.0000000000003780. Epub ahead of print. PMID: 36913629.

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