Neovascular glaucoma

Question 1

What is the aetiology of neovascular glaucoma?

Answer 1

Develops secondary to Rubeosis Irides

Secondary to proliferative Diabetic retinopathy and ischaemic CRVO

Question 2

What is neovascular glaucoma?

Answer 2

new vessels grow across iris surface from pupillary margin, towards iris root

➢ Invasion of AC angle and trabecular meshwork by neovascular tissue (fibrovascular membrane formation)

Question 3

What is the pathogenesis of Secondary Open Angle Neovascular glaucoma:

Answer 3

• Due to ischamic environment new vessels grow causing a fibrovascular membrane
  to block the trabecular meshwork.
• This prevents aqueous outflow and IOP rises.

Question 4

What is the pathogenesis of Secondary Closed Angle Neovascular glaucoma:

Answer 4

• The new vessel’s fibrovascular membrane contracts pulling the peripheral iris over the trabeculum, closing the angle.

This makes the IOP greater than the open angle one.

Question 5

What are the signs of neovascular glaucoma?

Answer 5

Red spots/tufts at the pupillary margin growing radially across the iris.
- Raised IOP
- Red Eye

Question 6

What are the symptoms of neovascular glaucoma?

Answer 6

• Painful
• Red eye
• Halo’s around light
• Blurred vision

Question 7

What is the management of neovascular glaucoma

Answer 7

emergency same day referral

Question 8

What is the treatment of neovas glaucoma?

Answer 8

Treat underlying cause: pan retinal photocoagulation anti-VEGF injections (e.g. Lucentis)
* Medical treatment for IOP (prostaglandins)