Abstract:

 Objective To investigate clinical etiological and therapeutic changes trend of neovascular glaucoma(NVG) from 2002 to 2016. Design Retrospective case series. Participants the NVG inpatients in Beijing Tongren Hospital from 2002 to 2016. Methods Totally 1094 cases (1152 eyes) of consecutive NVG inpatients were enrolled and reviewed. The gender, age, etiology were compared between two periods (in 2002-2006 and in 2012-2016). For therapeutic analysis, taking 2013 as a key point when anti-VEGF drugs were widely used, operation method of NVG was analyzed. Main Outcome Measures the constituent ratio of etiological and operative methods. Results The first clinical etiology of NVG both in 2002-2006 group (121 cases) and in 2012-2016 group (486 cases) were diabetic retinopathy (54.5%, 52.1%), followed by retinal vein occlusion (33.1% , 26.7%). Cases of central retinal artery occlusion and intraocular tumor increased significantly in 2012-2016. Coats disease (36.4%) was the most common original disease in children. Cyclodestructive procedures were the most popular (37.2%) before 2013, then significantly decreased to 18.1% (χ2=53.997, P=0.000), while vitreous injection of anti-VEGF drugs were the first therapy after 2013, of which composition ratio increased from 2.9% to 45.1% (χ2=246.599, P=0.000). External filtration was decreased from 32.6% to 16.6% (χ2=38.495, P=0.000), and retinal photocoagulation or condensation combined ciliary body damage was decreased from 11.1% to 2.2% (χ2=38.495, P=0.000). If the cases of simple vitreous anti-VEGF drugs were removed, the first therapy was ciliary body destructive surgery in both periods, and the second was external filtration(all P>0.05). Conclusion The clinical demographic characteristics and etiological change trend of NVG in 2002-2016 don’t change too much. The first etiology of NVG is diabetic retinopathy, followed by retinal vein occlusion. As the clinical application of anti-VEGF drugs, the cases accepted anti-VEGF treatment are significantly increased, and becomes the first therapy of NVG instead of ciliary body destructive surgery. The ciliary body destructive surgery and trabeculectomy were decreased, but are still main operation methods. (Ophthalmol CHN, 2019, 28: 11-16)

Key words:  neovascular glaucoma, etiology, constituent ratio；anti-VEGF