The Burden and Clinical Features of Neovascular Glaucoma in A Major Tertiary Care Center in China

Huishan Lin; Xinbo Gao; Zixing Xu; Yuxuan Zhang; Yunru Liao; Jiawei Ren; Xi Qin; Yao Liu; Wei Huang; Chengguo Zuo; Mingkai Lin

doi:10.1097/IJG.0000000000002497

The Burden and Clinical Features of Neovascular Glaucoma in A Major Tertiary Care Center in China

J Glaucoma. 2024 Sep 17. doi: 10.1097/IJG.0000000000002497. Online ahead of print.

Authors

Huishan Lin^{1

2

3}, Xinbo Gao^{1

2

3}, Zixing Xu⁴, Yuxuan Zhang⁴, Yunru Liao⁵, Jiawei Ren⁶, Xi Qin^{1

2

3}, Yao Liu^{1

2

3}, Wei Huang^{1

2

3}, Chengguo Zuo^{1

2

3}, Mingkai Lin^{1

2

3}

Affiliations

¹ State Key Laboratory of Ophthalmology, Guangzhou 510060, China.
² Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
³ Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China.
⁴ Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510060, China.
⁵ Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510060, China.
⁶ Department of Ophthalmology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710000, China.

PMID: 39283689
DOI: 10.1097/IJG.0000000000002497

Abstract

Prcis: This research presents the burden and clinical characteristics of NVG in Zhongshan Ophthalmic Center, employing the most extensive sample size and the longest uninterrupted temporal duration so far, which may provide a theoretical reference for the effective prevention and diagnosis of NVG.

Purpose: To summarize the burden and clinical characteristics of neovascular glaucoma (NVG) in a major tertiary care center in China.

Methods: The clinical data of NVG patients in Zhongshan Ophthalmic Center (ZOC) between 2012 and 2021 were collected retrospectively, including their age, sex, affected eye, best-corrected visual acuity (BCVA), intraocular pressure (IOP), clinical stage and aetiology.

Results: In this study, we included 1877 eyes of 1749 patients who developed NVG, with 2.01:1 ratio of male to female. Their mean age was 53.14±16.69 years and those aged 41-70 years (65.2%) were most affected. Monocular patients were more predominant in most of them (92.7%), while 7.3% were binocular and 1667 eyes (88.8%) were at the angle‑closure stage. The BCVA and IOP were 2.42±0.70 logMAR and 38.6±12.2 mmHg, respectively. Over the decade, the number of NVG patients and the proportion of NVG patients among glaucoma patients showed an increasing trend, with annual percentage changes (APCs) of 9.1% (95% CI: 5.0-13.3%, P=0.001) and 4.8% (95% CI: 2.2-7.4%, P=0.003), respectively. The top three primary conditions were diabetic retinopathy (DR), retinal vein occlusion (RVO), and retinal detachment (RD). Moreover, the APCs for the constituent ratio of DR and RVO were 4.4% (95% CI: 0.5-8.4%, P=0.031) and ﹣4.6% (95% CI: ﹣8.4% to ﹣0.7%, P=0.028), respectively. However, the first and second causes of NVG in minors (<18 years old) were Coat's disease and ocular tumours, followed by RD and RVO in third place. The top cause of NVG in patients aged 65 years and older was RVO.

Conclusions: The burden of NVG is increasing, emphasizing the need to improve preventive strategies focusing on primary diseases such as DR, RVO, and RD, particularly the increasing proportion of DR cases and the previously underemphasized RD patients, while also highlighting the differences in primary diseases across different age groups.