Neovascular glaucoma (NVG) is a secondary glaucoma generally associated with poor visual prognosis. The development of new vessels over the iris and the iridocorneal angle can obstruct aqueous humor outflow and lead to increased intraocular pressure. The underlying pathogenesis in most cases is posterior segment ischemia, which is most commonly secondary to proliferative diabetic retinopathy or central vein retinal occlusion. The neovascularization process in the eye is driven by the events that alter the homeostatic balance between pro-angiogenic factors, such as the vascular endothelial growth factor and anti-angiogenic factors, such as the pigment-epithelium-derived factor. Early diagnosis of this condition through slit lamp examination of the iris, iridocorneal angle and retina can help to avoid the development of goniosynechia and obstruction of aqueous humor outflow, with consequent intraocular pressure elevation. Historically, NVG treatment was focused on reducing the posterior segment ischemic process that caused the formation of new vessels, through panretinal photocoagulation. Recently, several studies have investigated the application of intravitreal anti-VEGF therapies in NVG. If clinical treatment with the use of hypotensive topical drops is not sufficient, laser and/or surgical procedures are required for intraocular pressure control.

/pdf/neovascular-glaucoma-a-review-30k3ctwz3m.pdf

Neovascular glaucoma: a review

The electrical and secretory activities of mouse pituitary tumor cells (AtT-20/D-16v), which contain and release the ACTH/beta-endorphin family of peptides, were studied by means of intracellular recordings and radioimmunoassays. Injection of depolarizing current pulses evoked action potentials in all cells and the majority (82%) displayed spontaneous action potential activity. Action potentials were found to be calcium-dependent. Barium increased membrane resistance, action potential amplitude and duration, and release of ACTH and beta-endorphin immunoactivity. Isoproterenol increased both action potential frequency and hormone secretion. Raising the external calcium concentration increased the frequency and amplitude of the action potentials and stimulated secretion of ACTH and beta-endorphin immunoactivity. Thus, stimulation of secretory activity in AtT-20 cells was closely correlated with increased electrical activity. However, a complete blockade of action potential activity had no effect on basal hormone secretion in these cells. These results suggest that the mechanisms underlying stimulated hormone secretion are different from those responsible for basal secretory activity. It is proposed that the increased influx of calcium due to the increased action potential frequency initiates the stimulated release of hormone from these cells.

/pdf/correlation-between-electrical-activity-and-acth-beta-3jwtyst7gr.pdf

Correlation between electrical activity and ACTH/beta-endorphin secretion in mouse pituitary tumor cells.

Background: Trans-scleral cyclophotocoagulation with diode laser has been well documented in the management of neovascular glaucoma. More recently, intravitreal bevacizumab has been increasingly employed to treat neovascular diseases of the eye. This study reports our initial experience with trans-scleral cyclophotocoagulation alone versus the combination of trans-scleral cyclophotocoagulation and intravitreal bevacizumab for management of neovascular glaucoma. Design: Retrospective uncontrolled comparative case series Participants: A total of 31 eyes of 30 consecutive patients were included - 11 eyes in the trans-scleral cyclophotocoagulation alone group and 20 in the combination trans-scleral cyclophotocoagulation and intravitreal bevacizumab group. Methods: The records of all patients diagnosed with neovascular glaucoma undergoing trans-scleral cyclophotocoagulation with or without intravitreal bevacizumab performed by a single ophthalmic surgeon in a glaucoma specialist centre were reviewed. Main Outcome Measures: Data collected included intraocular pressure, anterior segment neovascularisation, best-corrected visual acuity, use of medications and complications. Results: Mean reduction in intraocular pressure was 33.5mmHg in the trans-scleral cyclophotocoagulation group and 23.7mmHg in the combination group, a difference of 9.8mmHg (95% CI -1.5, 21.1). Complications included hypotony in three (27%) eyes in the trans-scleral cyclophotocoagulation group and two (10%) eyes in the combination group. Three eyes required evisceration. Conclusions: Trans-scleral cyclophotocoagulation alone is effective in lowering intraocular pressure in neovascular glaucoma. In this study, the addition of intravitreal bevacizumab to trans-scleral cyclophotocoagulation did not statistically advantage treatment outcomes. © 2010 The Authors. Clinical and Experimental Ophthalmology

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1442-9071.2010.02449.x

Management of neovascular glaucoma with transscleral cyclophotocoagulation with diode laser alone versus combination transscleral cyclophotocoagulation with diode laser and intravitreal bevacizumab

Neovascular glaucoma (NVG) is a devastating secondary glaucoma characterized by the appearance of neovascular over the iris and the proliferation of fibrovascular tissue in the anterior chamber angle. Proliferative diabetic retinopathy (PDR) is one of the leading causes of NVG. Currently increasing diabetes population drive the prevalence rate of NVG into a fast-rising lane. The pathogenesis underlying NVG makes it refractory to routine management for other types of glaucoma in clinical practice. The combination of panretinal photocoagulation (PRP), anti-vascular endothelial growth factor (VEGF) injections, anti-glaucoma drugs, surgical intervention as well as blood glucose control is needed. Early diagnosis and aggressive treatment in time are crucial in halting the neovascularization process and preserving vision. This review provides an overview of NVG secondary to diabetic retinopathy (DR), including the epidemiology, pathogenesis and management, so as to provide a better understanding as well as potential therapeutic strategies for future treatment.

/pdf/the-mechanism-and-therapeutic-strategies-for-neovascular-2zto5mtk.pdf

The mechanism and therapeutic strategies for neovascular glaucoma secondary to diabetic retinopathy

A number of antivascular endothelial growth factor agents are currently available to treat various ocular conditions. These agents have similar, but distinct, biologic qualities and have been explored in the management of neovascular glaucoma and in glaucoma surgery. Several different delivery methods are described, and because these medications are routinely given as intraocular injections, some benefits over traditional antifibrotic medications when used in glaucoma surgery are noted. These agents effectively induce regression of anterior segment neovascularization and facilitate initial surgical management of neovascular glaucoma, but the long-term outcome of this condition remains dependent on definitive management of the underlying process. Use in trabeculectomy or tube shunt procedures for other types of glaucoma has shown promise in modulating bleb morphology but has not yet been found to be as effective as traditional antifibrotic agents. There are reports of persistently raised intraocular pressure after repeated use of the anti-VEGF agents, possibly related to frequency of injection. These medications have wide application in the field of surgical glaucoma, but a definitive role has yet to be defined.

/pdf/use-of-anti-vegf-agents-in-glaucoma-surgery-3w1bfynrmk.pdf

Use of Anti-VEGF Agents in Glaucoma Surgery

Background: Intravitreal injection of bevacizumab (Avastin) in eyes with neovascular glaucoma (NVG) has recently been shown to induce rapid regression of anterior segment neovascularization and has promise as adjunct treatment to diode laser cyclophotocoagulation (CPC) to control intraocular pressure (IOP). This study presents the outcome of concomitant treatment with CPC and intravitreal bevacizumab in painful poor visual potential eyes in a case series of consecutively diagnosed NVG.



Methods:  Twelve patients (14 eyes) were treated with CPC and concurrent intravitreal bevacizumab 0.05 mL (1.25 mg) and study end-points were IOP lowering, regression of anterior segment neovascularization and resolution of pain.



Results:  The mean preoperative IOP was 42.1 ± 11.4 and was lowered to 16.6 ± 7.1 mmHg at 1-month postoperatively. Anterior segment neovascularization regressed dramatically within 1 week of intravitreal bevacizumab in 12 eyes. Thirteen eyes reported persistent relief of ocular pain at 6 months following treatment.



Conclusions:  Combined intravitreal bevacizumab and CPC treatment for NVG provides rapid control of anterior segment neovascularization and may lead to improved symptomatic relief and IOP control.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1442-9071.2010.02285.x

Combined diode laser cyclophotocoagulation and intravitreal bevacizumab (Avastin) in neovascular glaucoma.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Michael Shiu

Author Tools

Chat about Author

Papers

Combined diode laser cyclophotocoagulation and intravitreal bevacizumab (Avastin) in neovascular glaucoma.