Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential
Purpose To compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems. Methods Retrospective chart review of consecutive patients with NVG who presented between January 2016...
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| Veröffentlicht in: | International ophthalmology 2021-07, Vol.41 (7), p.2359-2368 |
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| creator | Rani, Padmaja Kumari Sen, Piyali Sahoo, Niroj Kumar Senthil, Sirisha Chakurkar, Renuka Anup, Manju Behera, Umesh Chandra Sivaprasad, Sobha Das, Taraprasad |
| description | Purpose
To compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems.
Methods
Retrospective chart review of consecutive patients with NVG who presented between January 2016 to January 2018 in 5 tertiary-centres in India and one eye-specialist centre in London (UK) was performed. The baseline characteristics, treatment provisions, and visual outcomes in the India and UK cohorts were compared.
Results
At presentation, 18% (83 of 451) and 22% (59 of 270) of patients with NVG had VA 6/60 or better in India and the UK cohorts, respectively. The aetiologies of NVG were similar with proliferative diabetic retinopathy being the most common cause (60.9%, India; 64.4%, UK;
p
= 0.38). Previous panretinal photocoagulation was more prevalent in the UK cohort compared to the India cohort (94.9% versus 66.3%, respectively;
p
|
| doi_str_mv | 10.1007/s10792-021-01789-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2503673290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2503673290</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-df2537b202098c8510830f8a2ecc6911950b5204def80b3fe5f4ec46c6b27a713</originalsourceid><addsrcrecordid>eNp9kLtOxDAQRS0EguXxAxTIEg1NYGzHcVwixEtCooGGxnKcyRKUxIudgPbv8bI8JAoqF_fMHc8h5JDBKQNQZ5GB0jwDzjJgqtTZcoPMmFQi44WATTIDVshMKmA7ZDfGFwDQShfbZEcIlUsQakae7qfR-R4j9Q0d0L_Z6KbOBjrv7JQCS9uB4jLli4ARh7Ed5vS9HZ9p72sMdkQ6ejr3vqZvbZxsRxd-XGG22ydbje0iHny9e-Tx6vLh4ia7u7--vTi_y5xQcszqhkuhKg4cdOlKyaAU0JSWo3OFZkxLqCSHvMamhEo0KJscXV64ouLKKib2yMm6dxH864RxNH0bHXadTfdM0fB0aaEE15DQ4z_oi5_CkH6XqFwqLVW5oviacsHHGLAxi9D2NiwNA7Myb9bmTTJvPs2bZRo6-qqeqh7rn5Fv1QkQayCmaJhj-N39T-0HsKWPDg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2545795780</pqid></control><display><type>article</type><title>Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Rani, Padmaja Kumari ; Sen, Piyali ; Sahoo, Niroj Kumar ; Senthil, Sirisha ; Chakurkar, Renuka ; Anup, Manju ; Behera, Umesh Chandra ; Sivaprasad, Sobha ; Das, Taraprasad</creator><creatorcontrib>Rani, Padmaja Kumari ; Sen, Piyali ; Sahoo, Niroj Kumar ; Senthil, Sirisha ; Chakurkar, Renuka ; Anup, Manju ; Behera, Umesh Chandra ; Sivaprasad, Sobha ; Das, Taraprasad ; India Retinal Disease Study Group ; on behalf of India Retinal Disease Study Group</creatorcontrib><description>Purpose
To compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems.
Methods
Retrospective chart review of consecutive patients with NVG who presented between January 2016 to January 2018 in 5 tertiary-centres in India and one eye-specialist centre in London (UK) was performed. The baseline characteristics, treatment provisions, and visual outcomes in the India and UK cohorts were compared.
Results
At presentation, 18% (83 of 451) and 22% (59 of 270) of patients with NVG had VA 6/60 or better in India and the UK cohorts, respectively. The aetiologies of NVG were similar with proliferative diabetic retinopathy being the most common cause (60.9%, India; 64.4%, UK;
p
= 0.38). Previous panretinal photocoagulation was more prevalent in the UK cohort compared to the India cohort (94.9% versus 66.3%, respectively;
p
< 0.001). The mean number of intravitreal anti-VEGF injections per eye was higher in the Indian cohort (1.65 ± 0.97 versus 1.14 ± 1.02 injections;
p
< 0.001). The number of eyes with closed angles (36.9% India versus 30.5% UK;
p
= 0.45) and the number of eyes needing glaucoma interventions (52.1% India; 62.7% UK;
p
= 0.82) were similar in two cohorts. Among glaucoma surgeries, trabeculectomies were more commonly performed in the Indian cohort (23 vs 4;
p
< 0.001),while glaucoma drainage device surgeries were more prevalent in the UK cohort (18 vs 4
p
< 0.001). After a median follow-up of 21 months (IQR 8.4–34.8 India; 24–36 months UK), favourable visual outcomes (vision stable or improved) were similar in both health systems (52.5% in the Indian cohort vs 43.4% in the UK cohort;
p
= 0.28). On multivariate regression analysis, the need for trans-scleral cyclophotocoagulation was associated with worse visual outcomes in both cohorts.
Conclusions
The causes and clinical profile of neovascular glaucoma with presenting visual acuity 6/60 or better in India and the UK were similar. Only up to 50% of eyes achieved favourable visual outcomes with current management protocols in both health systems.</description><identifier>ISSN: 0165-5701</identifier><identifier>EISSN: 1573-2630</identifier><identifier>DOI: 10.1007/s10792-021-01789-y</identifier><identifier>PMID: 33745037</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Acuity ; Angiogenesis Inhibitors - therapeutic use ; Bevacizumab - therapeutic use ; Diabetes mellitus ; Diabetic retinopathy ; Eye ; Eye (anatomy) ; Glaucoma ; Glaucoma, Neovascular - diagnosis ; Glaucoma, Neovascular - epidemiology ; Glaucoma, Neovascular - etiology ; Health services ; Humans ; India - epidemiology ; Intraocular Pressure ; Medicine ; Medicine & Public Health ; Ophthalmology ; Original Paper ; Patients ; Regression analysis ; Retinopathy ; Retrospective Studies ; Surgery ; Vascular endothelial growth factor ; Visual acuity</subject><ispartof>International ophthalmology, 2021-07, Vol.41 (7), p.2359-2368</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2021</rights><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-df2537b202098c8510830f8a2ecc6911950b5204def80b3fe5f4ec46c6b27a713</citedby><cites>FETCH-LOGICAL-c375t-df2537b202098c8510830f8a2ecc6911950b5204def80b3fe5f4ec46c6b27a713</cites><orcidid>0000-0001-7069-8238</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10792-021-01789-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10792-021-01789-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33745037$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rani, Padmaja Kumari</creatorcontrib><creatorcontrib>Sen, Piyali</creatorcontrib><creatorcontrib>Sahoo, Niroj Kumar</creatorcontrib><creatorcontrib>Senthil, Sirisha</creatorcontrib><creatorcontrib>Chakurkar, Renuka</creatorcontrib><creatorcontrib>Anup, Manju</creatorcontrib><creatorcontrib>Behera, Umesh Chandra</creatorcontrib><creatorcontrib>Sivaprasad, Sobha</creatorcontrib><creatorcontrib>Das, Taraprasad</creatorcontrib><creatorcontrib>India Retinal Disease Study Group</creatorcontrib><creatorcontrib>on behalf of India Retinal Disease Study Group</creatorcontrib><title>Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential</title><title>International ophthalmology</title><addtitle>Int Ophthalmol</addtitle><addtitle>Int Ophthalmol</addtitle><description>Purpose
To compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems.
Methods
Retrospective chart review of consecutive patients with NVG who presented between January 2016 to January 2018 in 5 tertiary-centres in India and one eye-specialist centre in London (UK) was performed. The baseline characteristics, treatment provisions, and visual outcomes in the India and UK cohorts were compared.
Results
At presentation, 18% (83 of 451) and 22% (59 of 270) of patients with NVG had VA 6/60 or better in India and the UK cohorts, respectively. The aetiologies of NVG were similar with proliferative diabetic retinopathy being the most common cause (60.9%, India; 64.4%, UK;
p
= 0.38). Previous panretinal photocoagulation was more prevalent in the UK cohort compared to the India cohort (94.9% versus 66.3%, respectively;
p
< 0.001). The mean number of intravitreal anti-VEGF injections per eye was higher in the Indian cohort (1.65 ± 0.97 versus 1.14 ± 1.02 injections;
p
< 0.001). The number of eyes with closed angles (36.9% India versus 30.5% UK;
p
= 0.45) and the number of eyes needing glaucoma interventions (52.1% India; 62.7% UK;
p
= 0.82) were similar in two cohorts. Among glaucoma surgeries, trabeculectomies were more commonly performed in the Indian cohort (23 vs 4;
p
< 0.001),while glaucoma drainage device surgeries were more prevalent in the UK cohort (18 vs 4
p
< 0.001). After a median follow-up of 21 months (IQR 8.4–34.8 India; 24–36 months UK), favourable visual outcomes (vision stable or improved) were similar in both health systems (52.5% in the Indian cohort vs 43.4% in the UK cohort;
p
= 0.28). On multivariate regression analysis, the need for trans-scleral cyclophotocoagulation was associated with worse visual outcomes in both cohorts.
Conclusions
The causes and clinical profile of neovascular glaucoma with presenting visual acuity 6/60 or better in India and the UK were similar. Only up to 50% of eyes achieved favourable visual outcomes with current management protocols in both health systems.</description><subject>Acuity</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Bevacizumab - therapeutic use</subject><subject>Diabetes mellitus</subject><subject>Diabetic retinopathy</subject><subject>Eye</subject><subject>Eye (anatomy)</subject><subject>Glaucoma</subject><subject>Glaucoma, Neovascular - diagnosis</subject><subject>Glaucoma, Neovascular - epidemiology</subject><subject>Glaucoma, Neovascular - etiology</subject><subject>Health services</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Intraocular Pressure</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Ophthalmology</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Retinopathy</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Vascular endothelial growth factor</subject><subject>Visual acuity</subject><issn>0165-5701</issn><issn>1573-2630</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kLtOxDAQRS0EguXxAxTIEg1NYGzHcVwixEtCooGGxnKcyRKUxIudgPbv8bI8JAoqF_fMHc8h5JDBKQNQZ5GB0jwDzjJgqtTZcoPMmFQi44WATTIDVshMKmA7ZDfGFwDQShfbZEcIlUsQakae7qfR-R4j9Q0d0L_Z6KbOBjrv7JQCS9uB4jLli4ARh7Ed5vS9HZ9p72sMdkQ6ejr3vqZvbZxsRxd-XGG22ydbje0iHny9e-Tx6vLh4ia7u7--vTi_y5xQcszqhkuhKg4cdOlKyaAU0JSWo3OFZkxLqCSHvMamhEo0KJscXV64ouLKKib2yMm6dxH864RxNH0bHXadTfdM0fB0aaEE15DQ4z_oi5_CkH6XqFwqLVW5oviacsHHGLAxi9D2NiwNA7Myb9bmTTJvPs2bZRo6-qqeqh7rn5Fv1QkQayCmaJhj-N39T-0HsKWPDg</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Rani, Padmaja Kumari</creator><creator>Sen, Piyali</creator><creator>Sahoo, Niroj Kumar</creator><creator>Senthil, Sirisha</creator><creator>Chakurkar, Renuka</creator><creator>Anup, Manju</creator><creator>Behera, Umesh Chandra</creator><creator>Sivaprasad, Sobha</creator><creator>Das, Taraprasad</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7069-8238</orcidid></search><sort><creationdate>20210701</creationdate><title>Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential</title><author>Rani, Padmaja Kumari ; Sen, Piyali ; Sahoo, Niroj Kumar ; Senthil, Sirisha ; Chakurkar, Renuka ; Anup, Manju ; Behera, Umesh Chandra ; Sivaprasad, Sobha ; Das, Taraprasad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-df2537b202098c8510830f8a2ecc6911950b5204def80b3fe5f4ec46c6b27a713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acuity</topic><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Bevacizumab - therapeutic use</topic><topic>Diabetes mellitus</topic><topic>Diabetic retinopathy</topic><topic>Eye</topic><topic>Eye (anatomy)</topic><topic>Glaucoma</topic><topic>Glaucoma, Neovascular - diagnosis</topic><topic>Glaucoma, Neovascular - epidemiology</topic><topic>Glaucoma, Neovascular - etiology</topic><topic>Health services</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Intraocular Pressure</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Ophthalmology</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Retinopathy</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Vascular endothelial growth factor</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rani, Padmaja Kumari</creatorcontrib><creatorcontrib>Sen, Piyali</creatorcontrib><creatorcontrib>Sahoo, Niroj Kumar</creatorcontrib><creatorcontrib>Senthil, Sirisha</creatorcontrib><creatorcontrib>Chakurkar, Renuka</creatorcontrib><creatorcontrib>Anup, Manju</creatorcontrib><creatorcontrib>Behera, Umesh Chandra</creatorcontrib><creatorcontrib>Sivaprasad, Sobha</creatorcontrib><creatorcontrib>Das, Taraprasad</creatorcontrib><creatorcontrib>India Retinal Disease Study Group</creatorcontrib><creatorcontrib>on behalf of India Retinal Disease Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rani, Padmaja Kumari</au><au>Sen, Piyali</au><au>Sahoo, Niroj Kumar</au><au>Senthil, Sirisha</au><au>Chakurkar, Renuka</au><au>Anup, Manju</au><au>Behera, Umesh Chandra</au><au>Sivaprasad, Sobha</au><au>Das, Taraprasad</au><aucorp>India Retinal Disease Study Group</aucorp><aucorp>on behalf of India Retinal Disease Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential</atitle><jtitle>International ophthalmology</jtitle><stitle>Int Ophthalmol</stitle><addtitle>Int Ophthalmol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>41</volume><issue>7</issue><spage>2359</spage><epage>2368</epage><pages>2359-2368</pages><issn>0165-5701</issn><eissn>1573-2630</eissn><abstract>Purpose
To compare the disease characteristics and treatment outcomes of patients with neovascular glaucoma (NVG) presenting with visual acuity (VA) 6/60 or better in two different health systems.
Methods
Retrospective chart review of consecutive patients with NVG who presented between January 2016 to January 2018 in 5 tertiary-centres in India and one eye-specialist centre in London (UK) was performed. The baseline characteristics, treatment provisions, and visual outcomes in the India and UK cohorts were compared.
Results
At presentation, 18% (83 of 451) and 22% (59 of 270) of patients with NVG had VA 6/60 or better in India and the UK cohorts, respectively. The aetiologies of NVG were similar with proliferative diabetic retinopathy being the most common cause (60.9%, India; 64.4%, UK;
p
= 0.38). Previous panretinal photocoagulation was more prevalent in the UK cohort compared to the India cohort (94.9% versus 66.3%, respectively;
p
< 0.001). The mean number of intravitreal anti-VEGF injections per eye was higher in the Indian cohort (1.65 ± 0.97 versus 1.14 ± 1.02 injections;
p
< 0.001). The number of eyes with closed angles (36.9% India versus 30.5% UK;
p
= 0.45) and the number of eyes needing glaucoma interventions (52.1% India; 62.7% UK;
p
= 0.82) were similar in two cohorts. Among glaucoma surgeries, trabeculectomies were more commonly performed in the Indian cohort (23 vs 4;
p
< 0.001),while glaucoma drainage device surgeries were more prevalent in the UK cohort (18 vs 4
p
< 0.001). After a median follow-up of 21 months (IQR 8.4–34.8 India; 24–36 months UK), favourable visual outcomes (vision stable or improved) were similar in both health systems (52.5% in the Indian cohort vs 43.4% in the UK cohort;
p
= 0.28). On multivariate regression analysis, the need for trans-scleral cyclophotocoagulation was associated with worse visual outcomes in both cohorts.
Conclusions
The causes and clinical profile of neovascular glaucoma with presenting visual acuity 6/60 or better in India and the UK were similar. Only up to 50% of eyes achieved favourable visual outcomes with current management protocols in both health systems.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>33745037</pmid><doi>10.1007/s10792-021-01789-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-7069-8238</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0165-5701 |
| ispartof | International ophthalmology, 2021-07, Vol.41 (7), p.2359-2368 |
| issn | 0165-5701 1573-2630 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Acuity Angiogenesis Inhibitors - therapeutic use Bevacizumab - therapeutic use Diabetes mellitus Diabetic retinopathy Eye Eye (anatomy) Glaucoma Glaucoma, Neovascular - diagnosis Glaucoma, Neovascular - epidemiology Glaucoma, Neovascular - etiology Health services Humans India - epidemiology Intraocular Pressure Medicine Medicine & Public Health Ophthalmology Original Paper Patients Regression analysis Retinopathy Retrospective Studies Surgery Vascular endothelial growth factor Visual acuity |
| title | Outcomes of neovascular glaucoma in eyes presenting with moderate to good visual potential |
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