alexa Retinal Photocoagulation Density in the Treatment of Neovascular Glaucoma due to Diabetic Retinopathy
ISSN: 2155-9570

Journal of Clinical & Experimental Ophthalmology
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Research Article

Retinal Photocoagulation Density in the Treatment of Neovascular Glaucoma due to Diabetic Retinopathy

Teruhiko Hamanaka1*, Takayasu Omata2, Noriko Akabane3, Toshihiro Yajima4 and Nobuo Ishida5
1Department of Ophthalmology, Japanese Red Cross Medical Center, Tokyo, Japan
2Omata Eye Clinic, Tokyo, Japan
3Akabane Eye Clinic, Tokyo, Japan
4Yajima Eye Clinic, Tokyo, Japan
5Ishida Eye Clinic, Jyoetsu city, Japan
Corresponding Author : Teruhiko Hamanaka
Department of Ophthalmology
Japanese Red Cross Medical Center
4-1-22 Hiroo, Shibuya- ku, Tokyo 150, Japan
Fax: +81-3-3409-1604
E-mail: [email protected]
Received June 12, 2012; Accepted July 12, 2012; Published July 20, 2012
Citation: Hamanaka T, Omata T, Akabane N, Yajima T, Ishida N(2012) Retinal Photocoagulation Density in the Treatment of Neovascular Glaucoma due to Diabetic Retinopathy. J Clinic Experiment Ophthalmol S4:007 doi: 10.4172/2155-9570.S4-007
Copyright: © 2012 Hamanaka T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Purpose: The risk factors for pan-retinal photocoagulation (PRP) failure and the efficacy of achieving a PRP burn density of ≥ 40% in the mid-periphery against diabetic neovascular glaucoma (NVG) were retrospectively evaluated.

Methods: All eyes were treated in order to exceed more than 40% PRP density by fluorescein fundus angiography before and after PRP. Risk factors for failed IOP control (≤22 mmHg or baseline) were evaluated by dividing into two groups; eyes received previous retinal photocoagulation (RP) before NVG (group I) and eyes with no RP before NVG (group II).

Results: Thirty one eyes of 25 patients were used (group I: 12 eyes, group II: 19 eyes).RP density before NVG in all eyes in group I was less than 40%. Risk factors for failed IOP control were prolonged PRP treatment of more than 12 months in group I (p=0.00053), and higher IOP at the diagnosis of NVG (p=0.01157), preexisting glaucoma or ocular hypertension (OH) (p=0.04664) and the persistence of optic disc neovascularization (NVD) in group II (p=0.01766).

Conclusion: Eyes with RP density of less than 40% may have a risk for later development of NVG. The prompt initiation of PRP, a PRP burn density of greater than 40%, and the completion of PRP within 6 months are strongly recommended for the treatment of NVG. Special care should be taken in NVG-affected eyes with small pupils, preexisting glaucoma or OH, or persistent NVD as well as those that are subjected to PRP for more than 12 months.


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