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Gazi Üniversitesi Tıp Fakültesi, Göz Hastalıkları A.D., Ankara, Doç. Dr. Neovascular glaucoma(NVG) is a devastating ocular disease that often results in loss of vision and loss of eye in some cases. The standard care includes retinal ablation in retinal ischemic diseases and control of increased intraocular pressure with medical and surgical therapy. Mediators that induce new vessel formation such as the vascular endothelial growth factor seem to play a key role in the pathophysiology of this condition. Over the past years several new agents targeting VEGF have become commercially available for intraocular use and intraocular use of anti-VEGF drugs have revolutionized the care of neovascular glaucoma.
Recommendations for the diagnosis of NVG include a high index of suspicion, a full ocular examination including undilated gonioscopy, and pupil examination. In regard to treatment, recommendations include treatment of the underlying disease, complete panretinal photocoagulation if retinal ischemia is a factor (especially in proliferative diabetic retinopathy), adjunctive intravitreal injections of anti- VEGF drugs and medical control of both elevated intraocular pressure and inflammation. Glaucoma surgery can be recommended to control intraocular pressure when medical therapy is not successful alone. Currently, trabeculectomy with antimetabolite therapy, aqueous shunt implants, and diode laser cyclophotocoagulation are the preferred surgical treatment options. Adjunctive intravitreal injection of anti-VEGF drugs previous to the surgery seems to be very helpful in reducing complications of glaucoma surgery and having higher success rates in NVG cases Keywords : Neovascular glaucoma, retinal ischemia, anti- VEGF