Changing epidemiology of neovascular glaucoma from 2002 to 2012 at King Khaled Eye Specialist Hospital, Saudi Arabia

Abdullah Al-Bahlal, Rajiv Khandekar, Khalid Al Rubaie, Tariq Alzahim, Deepak Edward, Igor Kozak

Research output: Contribution to journalArticle

Abstract

Purpose: The aim is to present the incidence and determinants of neovascular glaucoma (NVG) in Saudi Arabia. Methods: A retrospective review of NVG cases (2002-2012) was included to estimate the incidence. The determinants included gender, age, comorbidities, lens status, type of NVG, and visual acuity on presentation. The impact of antiangiogenic therapy on NVG incidence was studied. Results: We studied 597 eyes with NVG. The incidence was 6.6/10,000. It declined from 13/10,000 in 2008-0.1/10,000 in 2012 (P < 0.001). The decline in 2008 coincided with the introduction of intravitreal injection bevacizumab in Saudi Arabia. Males had a significantly higher NVG risk (odds ratio [OR] = 2.2). Diabetes and hypertension were associated with NVG in 88% and 42.7% of cases, respectively. In 377 (72%) diabetic patients, the glycemic control was poor (HbA1C >7%). Visual acuity was 20/20-20/40 in 14 (2%), 20/50-20/200 in 79 (13%), 20/200-20/400 in 456 (76%), and <20/400 in 45 (7%) eyes. Intraocular pressure was higher than 30 mmHg in 438 (73%) eyes. The cup-to-disc (CD) ratio was >0.8 in 86 (14%) eyes. During the early period (2002-2007) and later period (2008-2012), CD ratio (χ2 = 4, P = 0.09) and anterior chamber angle (P = 0.8) were not different. The presence of NVG in contralateral eye (OR = 0.8, P = 0.3) in both periods was similar. Conclusions: NVG was associated with diabetes in a very large proportion of patients. It was significantly associated with males, and with poor glycemic control and poor vision at presentation. The incidence of NVG declined after the introduction of intravitreal bevacizumab.

Original languageEnglish (US)
Pages (from-to)969-973
Number of pages5
JournalIndian Journal of Ophthalmology
Volume65
Issue number10
DOIs
StatePublished - Oct 1 2017

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Neovascular Glaucoma
Saudi Arabia
Epidemiology
Incidence
Visual Acuity
Anterior Chamber
Lenses
Comorbidity

Keywords

  • Diabetes
  • epidemiology
  • glaucoma
  • neovascular glaucoma
  • visual impairment

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Changing epidemiology of neovascular glaucoma from 2002 to 2012 at King Khaled Eye Specialist Hospital, Saudi Arabia. / Al-Bahlal, Abdullah; Khandekar, Rajiv; Al Rubaie, Khalid; Alzahim, Tariq; Edward, Deepak; Kozak, Igor.

In: Indian Journal of Ophthalmology, Vol. 65, No. 10, 01.10.2017, p. 969-973.

Research output: Contribution to journalArticle

Al-Bahlal, Abdullah ; Khandekar, Rajiv ; Al Rubaie, Khalid ; Alzahim, Tariq ; Edward, Deepak ; Kozak, Igor. / Changing epidemiology of neovascular glaucoma from 2002 to 2012 at King Khaled Eye Specialist Hospital, Saudi Arabia. In: Indian Journal of Ophthalmology. 2017 ; Vol. 65, No. 10. pp. 969-973.
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abstract = "Purpose: The aim is to present the incidence and determinants of neovascular glaucoma (NVG) in Saudi Arabia. Methods: A retrospective review of NVG cases (2002-2012) was included to estimate the incidence. The determinants included gender, age, comorbidities, lens status, type of NVG, and visual acuity on presentation. The impact of antiangiogenic therapy on NVG incidence was studied. Results: We studied 597 eyes with NVG. The incidence was 6.6/10,000. It declined from 13/10,000 in 2008-0.1/10,000 in 2012 (P < 0.001). The decline in 2008 coincided with the introduction of intravitreal injection bevacizumab in Saudi Arabia. Males had a significantly higher NVG risk (odds ratio [OR] = 2.2). Diabetes and hypertension were associated with NVG in 88{\%} and 42.7{\%} of cases, respectively. In 377 (72{\%}) diabetic patients, the glycemic control was poor (HbA1C >7{\%}). Visual acuity was 20/20-20/40 in 14 (2{\%}), 20/50-20/200 in 79 (13{\%}), 20/200-20/400 in 456 (76{\%}), and <20/400 in 45 (7{\%}) eyes. Intraocular pressure was higher than 30 mmHg in 438 (73{\%}) eyes. The cup-to-disc (CD) ratio was >0.8 in 86 (14{\%}) eyes. During the early period (2002-2007) and later period (2008-2012), CD ratio (χ2 = 4, P = 0.09) and anterior chamber angle (P = 0.8) were not different. The presence of NVG in contralateral eye (OR = 0.8, P = 0.3) in both periods was similar. Conclusions: NVG was associated with diabetes in a very large proportion of patients. It was significantly associated with males, and with poor glycemic control and poor vision at presentation. The incidence of NVG declined after the introduction of intravitreal bevacizumab.",
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AU - Al-Bahlal, Abdullah

AU - Khandekar, Rajiv

AU - Al Rubaie, Khalid

AU - Alzahim, Tariq

AU - Edward, Deepak

AU - Kozak, Igor

PY - 2017/10/1

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N2 - Purpose: The aim is to present the incidence and determinants of neovascular glaucoma (NVG) in Saudi Arabia. Methods: A retrospective review of NVG cases (2002-2012) was included to estimate the incidence. The determinants included gender, age, comorbidities, lens status, type of NVG, and visual acuity on presentation. The impact of antiangiogenic therapy on NVG incidence was studied. Results: We studied 597 eyes with NVG. The incidence was 6.6/10,000. It declined from 13/10,000 in 2008-0.1/10,000 in 2012 (P < 0.001). The decline in 2008 coincided with the introduction of intravitreal injection bevacizumab in Saudi Arabia. Males had a significantly higher NVG risk (odds ratio [OR] = 2.2). Diabetes and hypertension were associated with NVG in 88% and 42.7% of cases, respectively. In 377 (72%) diabetic patients, the glycemic control was poor (HbA1C >7%). Visual acuity was 20/20-20/40 in 14 (2%), 20/50-20/200 in 79 (13%), 20/200-20/400 in 456 (76%), and <20/400 in 45 (7%) eyes. Intraocular pressure was higher than 30 mmHg in 438 (73%) eyes. The cup-to-disc (CD) ratio was >0.8 in 86 (14%) eyes. During the early period (2002-2007) and later period (2008-2012), CD ratio (χ2 = 4, P = 0.09) and anterior chamber angle (P = 0.8) were not different. The presence of NVG in contralateral eye (OR = 0.8, P = 0.3) in both periods was similar. Conclusions: NVG was associated with diabetes in a very large proportion of patients. It was significantly associated with males, and with poor glycemic control and poor vision at presentation. The incidence of NVG declined after the introduction of intravitreal bevacizumab.

AB - Purpose: The aim is to present the incidence and determinants of neovascular glaucoma (NVG) in Saudi Arabia. Methods: A retrospective review of NVG cases (2002-2012) was included to estimate the incidence. The determinants included gender, age, comorbidities, lens status, type of NVG, and visual acuity on presentation. The impact of antiangiogenic therapy on NVG incidence was studied. Results: We studied 597 eyes with NVG. The incidence was 6.6/10,000. It declined from 13/10,000 in 2008-0.1/10,000 in 2012 (P < 0.001). The decline in 2008 coincided with the introduction of intravitreal injection bevacizumab in Saudi Arabia. Males had a significantly higher NVG risk (odds ratio [OR] = 2.2). Diabetes and hypertension were associated with NVG in 88% and 42.7% of cases, respectively. In 377 (72%) diabetic patients, the glycemic control was poor (HbA1C >7%). Visual acuity was 20/20-20/40 in 14 (2%), 20/50-20/200 in 79 (13%), 20/200-20/400 in 456 (76%), and <20/400 in 45 (7%) eyes. Intraocular pressure was higher than 30 mmHg in 438 (73%) eyes. The cup-to-disc (CD) ratio was >0.8 in 86 (14%) eyes. During the early period (2002-2007) and later period (2008-2012), CD ratio (χ2 = 4, P = 0.09) and anterior chamber angle (P = 0.8) were not different. The presence of NVG in contralateral eye (OR = 0.8, P = 0.3) in both periods was similar. Conclusions: NVG was associated with diabetes in a very large proportion of patients. It was significantly associated with males, and with poor glycemic control and poor vision at presentation. The incidence of NVG declined after the introduction of intravitreal bevacizumab.

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KW - visual impairment

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