ArticleClinical ophthalmology (Auckland, N.Z.)2026
Clinical Outcomes of Neovascular Glaucoma in Patients with Prior and Non-Prior Intravitreal Anti-VEGF Treatment: A Retrospective Cohort Study.
Article in Clinical ophthalmology (Auckland, N.Z.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To compare 1-year clinical outcomes between patients with neovascular glaucoma (NVG) who received intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy prior to NVG diagnosis and those who did not. Patients and Methods: This retrospective cohort study included patients newly diagnosed with NVG at King Chulalongkorn Memorial Hospital, Thailand, who completed a 1-year follow-up. Participants were categorized into a prior anti-VEGF group and a non-prior anti-VEGF group. Ocular characteristics, including intraocular pressure (IOP) and number of anti-glaucoma medications, were recorded at baseline and at 1, 3, 6, and 12 months. Best-corrected visual acuity (BCVA) and pan-retinal photocoagulation (PRP) status were assessed at baseline and 12 months. The number of post-enrollment anti-VEGF injections, requirement for glaucoma surgery, and NVG recurrence were evaluated at 12 months. Results: Seventy-three eyes from 73 patients were analyzed (18 prior anti-VEGF; 55 non-prior anti-VEGF). Both groups demonstrated significant IOP reduction at all follow-up visits compared with baseline (P<0.001), with no significant between-group differences at any time point (P=0.205-0.898). Anti-glaucoma medications use significantly decreased in the non-prior anti-VEGF group starting from 3-month follow-up (P<0.001), but not in the prior anti-VEGF group (P=0.082), with no significant between-group difference (P=0.586). The prior anti-VEGF group had a higher proportion of no light perception (P=0.047), although BCVA change did not differ significantly between groups (P=0.126). No significant between-group differences were observed in post-enrollment anti-VEGF injections, PRP status, glaucoma surgery, or NVG recurrence (P=0.504-0.920). Baseline IOP was significantly associated with time to first glaucoma surgery (β= -0.06, P=0.005). Conclusion: Although no significant differences in IOP reduction were observed between NVG patients with and without prior anti-VEGF treatment, both groups achieved significant IOP reduction following treatment initiation. Patients without prior anti-VEGF therapy demonstrated a greater reduction in medication burden at 1 year compared with those who had received prior anti-VEGF treatment.
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