Nazima Bai A, K. Kanchana
BACKGROUND Neovascular glaucoma (NVG) is a refractory type of glaucoma. In neovascular glaucoma elevation of IOP is caused by synechial angle closure through contraction of fibrovascular tissue. The symptoms of NVG are distressing, the visual loss severe and glaucoma intractable. Timely treatment with photocoagulation and Modified trabeculectomy and Artificial filtering shunts offers the patient a symptom-free life if not better vision. Intravitreal anti-VEGF cause rapid regression of iris and angle neovascularisation helping in the therapy of NVG. MATERIALS AND METHODS This is a descriptive study of the 66 cases of neovascular glaucoma attending a tertiary level hospital during the study period of 8 months. Treatments given included medical therapy, panretinal photocoagulation (PRP), injection Avastin, modified trabeculectomy, anterior retinal cryopexy (ARC) and cyclocryotherapy (CCT). The follow-up studies were done for a period of two to seven months in different cases. RESULTS Out of 66 cases two cases (2.9%) showed visual acuity improvement in the study. Both cases had undergone modified trabeculectomy with mitomycin C. One patient received preoperatively panretinal photocoagulation. Another patient received preoperatively panretinal photocoagulation and inj. bevacizumab. Both these cases have presented in the early stage of disease. Even though vision cannot be improved in majority of patients, the present modalities of treatment provide a painless eye without much of function. CONCLUSION The treatment should be based on the vision of the affected eye at the time of presentation and whether the angle is open or closed gonioscopically. Medical treatment was given for all patients for symptomatic relief. Majority had to undergo other modalities of treatment like panretinal photocoagulation (PRP), injection Avastin, modified trabeculectomy, and cyclocryotherapy (CCT).
