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All Journal Vision Science and Eye Health Journal Ophthalmologica Indonesiana
Malika, Rosalia Adriani
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Health Professions Medicine & Pharmacology Public Health

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Journal : Vision Science and Eye Health Journal

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The Challenges of Handling Neovascular Glaucoma at Undaan Eye Hospital Surabaya, Indonesia Malika, Rosalia Adriani; Nuradianti, Lydia
Vision Science and Eye Health Journal Vol. 3 No. 1 (2023): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i1.2023.8-11

Abstract

Introduction: Neovascular glaucoma (NVG) is a secondary glaucoma, frequently incurable, and can cause blindness. It is characterized by neovascularization over the iris, IOP elevation, and glaucomatous optic neuropathy. Retinal ischemia, which supplies the release of angiogenesis factors, is the leading factor of NVG. Anti-vascular endothelial growth factor (Anti-VEGF) agents are effective at iris and iridocorneal angle neovascularization. Furthermore, laser and surgery are still necessary to decrease intraocular pressure in the condition with ineffective medication. Delay in treatment can lead to sight-threatening glaucoma. Purpose: This study aimed to provide an overview of the incidence and management of NVG at Undaan Eye Hospital, Surabaya, Indonesia. Methods: This descriptive epidemiology study comprised 111 eyes of 102 patients. The inclusion criteria were patients diagnosed with NVG who came to Undaan Eye Hospital for one year (January 2021 to December 2021). Patients with incomplete medical records were excluded. The patient's age, gender, risk factors, and treatment were reviewed. Results: There were 102 patients (111 eyes) diagnosed with NVG. The patients were primarily men (53.2%), and the mean age was 54.98 ± 12.4 years. Diabetes mellitus (DM) was observed in 70 (63.1%) eyes, hypertension in 60 (54.1%) eyes, central retinal vein occlusion (CRVO) in 11 (9.9%) eyes, cholesterol in seven (6.3%) eyes, and branch retinal vein occlusion (BRVO) in one (0,9%) eye. The mean IOP at the time of diagnosis was 42.8 ± 11.2 mmHg. Anti-VEGF (25.2%), trabeculectomy (59.5%), glaucoma drainage device (17.1%), micropulse transscleral cyclophotocoagulation (5.4%) were done as an option of the treatment. Conclusions: NVG is more common in men. Most patients presenting NVG had DM and hypertension with a mean IOP of 42.8 mmHg. Trabeculectomy is the most commonly performed procedure.
The Comparison Between Results of Trabeculectomy With and Without Prior Anti-Vascular Endothelial Growth Factor In Patients With Neovascular Glaucoma at Undaan Eye Hospital Surabaya, Indonesia Malika, Rosalia Adriani; Nuradianti, Lydia
Vision Science and Eye Health Journal Vol. 4 No. 1 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i1.2024.24-26

Abstract

Introduction: New intraocular medication and anti-vascular endothelial growth factor (VEGF) agents have been developed to manage neovascular glaucoma and surgery. However, no studies compare trabeculectomy with anti-VEGF to no anti-VEGF treatment in patients with neovascular glaucoma. Purpose: This study compares the decrease of intraocular pressure (IOP) between trabeculectomy with and without anti-VEGF in neovascular glaucoma. Methods: This observational study comprised 30 medical records of neovascular glaucoma, divided into 15 medical records of patients with anti-VEGF before trabeculectomy and medical records of patients operated with trabeculectomy without anti-VEGF, monitored between January 2021 and December 2021. Patients with incomplete medical records were excluded. Data collected are age, gender, risk factor, IOP preoperative, and during six months of follow-up IOP postoperative. Data analysis uses an Independent T-test and Mann-Whitney test. Results: From 30 samples, the mean IOP in trabeculectomy with the anti-VEGF group generally is 12.26 mmHg. Meanwhile, the mean IOP in trabeculectomy without the anti-VEGF group generally is 16.74 mmHg. The comparison between two groups shows that there are significant mean differences between them during 1-5 months follow-up (1 month: p = 0.022; 2 months: p = 0.007; 3 months: p = 0.007; 4 months: p = 0.042; and 5 months: p = 0.029). Conclusions: Trabeculectomy with prior administration of intravitreal anti-VEGF shows good IOP reduction and can be implemented in neovascular glaucoma (NVG) patients.
Co-Authors Nuradianti , Lydia Nuradianti, Lydia