Management of patients with operated refractory neovascular glaucoma (clinical observation)
Introduction. Thrombosis (occlusion) of the central retinal vein (RCVO) and its branches is one of the main causes of loss or significant decrease in vision, including in people of working age, while RCVO is the second most common retinal vascular disease after diabetic retinopathy. The incidence ra...
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| Format: | Article |
| Language: | Russian |
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Remedium Group LLC
2021-09-01
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| Series: | Медицинский совет |
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| Online Access: | https://www.med-sovet.pro/jour/article/view/6372 |
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| author | A. A. Gamidov Z. V. Surnina I. V. Andreeva |
| author_facet | A. A. Gamidov Z. V. Surnina I. V. Andreeva |
| author_sort | A. A. Gamidov |
| collection | DOAJ |
| description | Introduction. Thrombosis (occlusion) of the central retinal vein (RCVO) and its branches is one of the main causes of loss or significant decrease in vision, including in people of working age, while RCVO is the second most common retinal vascular disease after diabetic retinopathy. The incidence rates steadily increase with age, amounting to 0.7% in the 49–60 age group and reaching 4.6% in people over 80 years old. Acute violation of retinal venous blood flow often leads to retinal ischemia, triggering the mechanism of activation of endothelial vascular growth factor (VEGF). In a quarter of patients, occlusions of the retinal veins and its branches initially proceed according to the ischemic type, which is characterized by the formation of extensive non-perfused retinal zones occupying an area of 10 or more areas of the optic nerve head (optic nerve disc) according to fluorescent angiography (FAG). In 34% of such patients, the non-ischemic type of venous occlusion becomes ischemic within 3 years.Aim. To develop an optimal algorithm for the management of patients with operated neovascular uncompensated glaucoma against the background of occlusion of the central retinal vein.Materials and methods. Two patients with operated secondary neovascular glaucoma of stage III-c. In the combined sequential therapy, the anti-VEGF medication Aflibercept (0.5 mg) was used, laser coagulation of residual newly formed vessels, laser reconstruction in the surgical area, contact transcleral cyclolazercoagulation, and laser coagulation of the peripheral parts of the retina were performed.Results. The combined sequential treatment, combined with the appointment of antihypertensive drugs in drops, allowed to stabilize the level of IOP. IOP indicators remained at the level of normal values during 1 year of follow-up.Conclusion. The use of combined laser technologies and anti-VEGF therapy allows potentiating and prolonging the hypotensive effect in the treatment of patients with operated secondary refractory neovascular glaucoma against the background of occlusion of the central retinal vein. |
| first_indexed | 2024-04-09T16:28:15Z |
| format | Article |
| id | doaj.art-1b371f35f62b4448bb3bb8d54622241c |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:28:15Z |
| publishDate | 2021-09-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-1b371f35f62b4448bb3bb8d54622241c2023-04-23T06:57:12ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-09-0101237437810.21518/2079-701X-2021-12-374-3785749Management of patients with operated refractory neovascular glaucoma (clinical observation)A. A. Gamidov0Z. V. Surnina1I. V. Andreeva2Research Institute of Eye DiseaseResearch Institute of Eye DiseaseResearch Institute of Eye DiseaseIntroduction. Thrombosis (occlusion) of the central retinal vein (RCVO) and its branches is one of the main causes of loss or significant decrease in vision, including in people of working age, while RCVO is the second most common retinal vascular disease after diabetic retinopathy. The incidence rates steadily increase with age, amounting to 0.7% in the 49–60 age group and reaching 4.6% in people over 80 years old. Acute violation of retinal venous blood flow often leads to retinal ischemia, triggering the mechanism of activation of endothelial vascular growth factor (VEGF). In a quarter of patients, occlusions of the retinal veins and its branches initially proceed according to the ischemic type, which is characterized by the formation of extensive non-perfused retinal zones occupying an area of 10 or more areas of the optic nerve head (optic nerve disc) according to fluorescent angiography (FAG). In 34% of such patients, the non-ischemic type of venous occlusion becomes ischemic within 3 years.Aim. To develop an optimal algorithm for the management of patients with operated neovascular uncompensated glaucoma against the background of occlusion of the central retinal vein.Materials and methods. Two patients with operated secondary neovascular glaucoma of stage III-c. In the combined sequential therapy, the anti-VEGF medication Aflibercept (0.5 mg) was used, laser coagulation of residual newly formed vessels, laser reconstruction in the surgical area, contact transcleral cyclolazercoagulation, and laser coagulation of the peripheral parts of the retina were performed.Results. The combined sequential treatment, combined with the appointment of antihypertensive drugs in drops, allowed to stabilize the level of IOP. IOP indicators remained at the level of normal values during 1 year of follow-up.Conclusion. The use of combined laser technologies and anti-VEGF therapy allows potentiating and prolonging the hypotensive effect in the treatment of patients with operated secondary refractory neovascular glaucoma against the background of occlusion of the central retinal vein.https://www.med-sovet.pro/jour/article/view/6372neovascular glaucomalaser coagulation of the retinacyclolaser coagulationintravitreal injectionsintraocular pressure |
| spellingShingle | A. A. Gamidov Z. V. Surnina I. V. Andreeva Management of patients with operated refractory neovascular glaucoma (clinical observation) Медицинский совет neovascular glaucoma laser coagulation of the retina cyclolaser coagulation intravitreal injections intraocular pressure |
| title | Management of patients with operated refractory neovascular glaucoma (clinical observation) |
| title_full | Management of patients with operated refractory neovascular glaucoma (clinical observation) |
| title_fullStr | Management of patients with operated refractory neovascular glaucoma (clinical observation) |
| title_full_unstemmed | Management of patients with operated refractory neovascular glaucoma (clinical observation) |
| title_short | Management of patients with operated refractory neovascular glaucoma (clinical observation) |
| title_sort | management of patients with operated refractory neovascular glaucoma clinical observation |
| topic | neovascular glaucoma laser coagulation of the retina cyclolaser coagulation intravitreal injections intraocular pressure |
| url | https://www.med-sovet.pro/jour/article/view/6372 |
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