Neovascular Glaucoma: Aetiology and Outcome of Treatment in Lagos University Teaching Hospital

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Rotimi-Samuel, A
Onakoya, A.O
Musa, K.O
Aribaba, O.T
Akinsola, F.B
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Nigerian Journal of Ophthalmology
Objective: This paper investigates the causes and the intraocular pressure outcome of neo-vascular glaucoma at Guinness Eye Centre, Lagos University Teaching Hospital, Lagos, Nigeria. Materials and Methods: The case records of all patients with the diagnosis of neo-vascular glaucoma who presented at the Guinness Eye Centre from 1st January, 2008 to 31st December, 2012 were reviewed. Information extracted from their records included the biodata, eye affected, best corrected visual acuity, intra-ocular pressure, aetiology of neo-vascular glaucoma, ocular co-morbidity, systemic co-morbidity and forms of treatment received. Cases of retinoblastoma were excluded from the study. Data were analysed using SPSS V.17. Results: Thirty-one cases of neo-vascular glaucoma were reviewed. The male to female ratio was 1.8:1 and the age ranged from 26 years to 83 years. Over 70% of the patients were 51 years and above. The best corrected visual acuity in the affected eye or in the worse affected eye was determined by counting fingers in 30 (96%) patients. The presenting IOP was 30mmHg and above in 26 (83.2%) patients. Both eyes were affected in 3 (9.6%) patients. Patients with diabetes mellitus and hypertension or both constituted 57.8% of the total number of patients. Primary open angle glaucoma and retinal vein occlusion were the aetiologies of neo-vascular glaucoma in 14 (45.2%) patients. A total of 15 (48.4%) patients failed to turn up for repeat appointments. Only, 5 (16.0%) patients who received medications, intravitreal bevacizumab and pan-retinal photocoagulation showed a significant intraocular pressure reduction. Conclusion: Late presentation, failure to follow up and lack of full and complete treatment were important findings in this study. A significant intraocular pressure reduction occurred only in the patients who had a combination therapy of intraocular pressure lowering medication, intravitreal bevacizumab and pan-retinal photocoagulation. A routine eye examination for patients at risk is essential for early detection and treatment in order to minimize visual loss in neo-vascular glaucoma.
Scholarly articles
Neo-vascular glaucoma , Late presentation , Early detection , Combination therapy , Research Subject Categories::MEDICINE
Rotimi-Samuel A, Onakoya A.O, Musa K.O, Aribaba O.T, Akinsola F.B. Neovascular Glaucoma. Aetiology and Outcome of Treatment in Lagos University Teaching Hospital. Niger J Ophthalmol 2013; 21(2):43-46