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
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.