J Korean Ophthalmol Soc.  2017 Apr;58(4):415-419. 10.3341/jkos.2017.58.4.415.

Prognostic Factors of Neovascular Glaucoma in Eyes with Treated Proliferative Diabetic Retinopathy

Affiliations
  • 1Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea. deenie@daum.net

Abstract

PURPOSE
To evaluate the factors that are significant in progression to neovascular glaucoma in patients with proliferative diabetic retinopathy.
METHODS
In this retrospective analysis, we reviewed the medical records of 52 patients who were first diagnosed with proliferative diabetic retinopathy from March 2014 to March 2016. We compared diabetes mellitus period, HbA1c, chronic diseases such as hypertension, hyperlipidemia, and kidney disease, insulin treatments, blood urea nitrogen, blood creatinine, glomerular filtration rate, urine albumin, dialysis, corrected visual acuity at the first visit, traction membrane sign of the retina at the first visit, vitreous hemorrhage and preretinal hemorrhage in each group and then investigated the prognostic factors of neovascular glaucoma.
RESULTS
A total of 52 patients were included in the investigation, 12 patients (23.08%) were diagnosed with iris neovascularization and 4 patients (7.69%) developed neovascular glaucoma. The patients without iris neovascularization were defined as Group I, those with iris neovascularization as Group II, and those with neovascular glaucoma as Group III. The diabetes mellitus period was significantly longer in Group II (10.88 ± 7.14 years) and in Group III (11.75 ± 8.61 years) than Group I (8.30 ± 5.25 years) (p-value 0.41, 0.032, respectively). The HbA1c level was 9.59 ± 2.23 in Group II and 9.27 ± 2.54 in Group I. There was no significant difference between the two groups (p = 0.721). However, HbA1c was significantly higher in Group III (11.55 ± 0.21) than Group I (p-value 0.048).
CONCLUSIONS
A long diabetes mellitus period and high HbA1c level have a significant effect on the progression to neovascular glaucoma in patients with proliferative diabetic retinopathy. This information could be useful for predicting and preventing the prognosis of patients.

Keyword

Diabetes mellitus; Hb1AC; Neovascular glaucoma; Proliferative diabetic retinopathy

MeSH Terms

Blood Urea Nitrogen
Chronic Disease
Creatinine
Diabetes Mellitus
Diabetic Retinopathy*
Dialysis
Glaucoma, Neovascular*
Glomerular Filtration Rate
Hemorrhage
Humans
Hyperlipidemias
Hypertension
Insulin
Iris
Kidney Diseases
Medical Records
Membranes
Prognosis
Retina
Retrospective Studies
Traction
Visual Acuity
Vitreous Hemorrhage
Creatinine
Insulin

Reference

1. Sivak-Callcott JA, O'Day DM, Gass JD, Tsai JC. Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma. Ophthalmology. 2001; 108:1767–1776. quiz 1777, 1800.
2. Ohrt V. The frequency of rubeosis iridis in diabetic patients. Acta Ophthalmol (Copenh). 1971; 49:301–307.
3. Madsen PH. Rubeosis of the iris and haemorrhagic glaucoma in patients with proliferative diabetic retinopathy. Br J Ophthmol. 1971; 55:368–371.
4. Shazly TA, Latina MA. Neovascular glaucoma: etiology, diagnosis and prognosis. Semin Ophthalmol. 2009; 24:113–121.
5. Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984; 91:1464–1474.
6. Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin epidemiologic study of diabetic retinopathy. XV. The long-term incidence of macular edema. Ophthalmology. 1995; 102:7–16.
7. Tripathi RC, Li J, Tripathi BJ, et al. Increased level of vascular endothelial growth factor in queous humor of patients with neovascular glaucoma. Ophthalmology. 1998; 105:232–237.
8. Wand M, Madigan JC, Gaudio AR, Sorokanich S. Neovascular glaucoma following pars plana vitrectomy for complication of diabetic retinopathy. Ophthalmic Surg. 1990; 21:113–118.
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