Glaucoma neovascular: estudo descritivo dos aspectos epidemiológicos e oftalmológicos. Proposta de um fluxograma na abordagem terapêutica

Glaucoma neovascular: estudo descritivo dos aspectos epidemiológicos e oftalmológicos. Proposta de um fluxograma na abordagem terapêutica


José Paulo Cabral de Vasconcellos,
Vital Paulino Costa,
Newton Kara-José


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.61 no.5 São Paulo out. 1998



To investigate: 1. The causes of neovascular glaucoma (NVG) in our population. 2. Possible factors related to the prognosis of NVG. 3. The results of the treatment of NVG.


Thirty-eight patients with a diagnosis of NVG, from September 1996 to March 1997, were retrospectively evaluated at the Glaucoma Service of the University of Campinas.


The most important cause of NVG was proliferative diabetic retinopathy, which was found in 18 patients (47.4%), whereas central retinal vein occlusion was observed in 14 patients (36.8%). The visual acuity at presentation was significantly related to the final visual acuity (p = 0.01). However, initial intraocular pressure and the extension of peripheral anterior sinechiae were not associated with the final visual acuity (p > O. 05). Among the 38 patients, 8 (21.1%) underwent a surgical procedure, which led to a significant decrease of intraocular pressure from 39.75 ± 10.99 mmHg to 21.88 ± 12.14 mmHg (p = 0.01). Five patients (13.1%) achieved IOP control following retinal ablation associated with treatment with drugs. The remaining 25 patients (65.8%) presented with very low visual acuities (light perception or less), which did not justify a surgical procedure. At the end of follow-up, 71.1% of the patients had visual acuity worse or equal to light perception.


NVG was found to be refractory to treatment and showed an unfavorable visual prognosis. In the attempt to avoid the unfavorable visual outcome of patients with NVG, a flow chart was proposed to guide the treatment of such patients.

Keywords: Neovascular glaucoma; Photocoagulation; Gonioscopy; Intraocular pressure


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