Hayreh Sohan Singh
Department of Ophthalmology and Visual Sciences, College of Medicine, University of Iowa Hospital and Clinics, Iowa City, IA, USA.
Prog Retin Eye Res. 2007 Sep;26(5):470-85. doi: 10.1016/j.preteyeres.2007.06.001. Epub 2007 Aug 8.
Neovascular glaucoma (NVG) is a severely blinding, intractable disease. The objective of this review is to provide detailed information on its basic and clinical aspects, to enable us to manage it logically. Therefore, its causes, pathogenesis and pathology, methods of early diagnosis and management are discussed. To prevent or reduce the extent of visual loss caused by NVG, the first essential is to have a high index of suspicion of its development. The most common diseases responsible for development of NVG are ischemic central retinal vein occlusion (CRVO), diabetic retinopathy and ocular ischemic syndrome. In the management strategy, the first priority should be to try to prevent its development by appropriate management of the causative diseases. If NVG develops, early diagnosis is crucial to reduce the extent of visual loss. Management of NVG primarily consists of controlling the high IOP by medical and/or surgical means to minimize the visual loss. Currently, we still do not have a satisfactory means of treating NVG and preventing visual loss in the majority, in spite of multiple modes of medical and surgical options advocated over the years and claims made. This review discusses the pros and cons for the various advocated treatments.
新生血管性青光眼(NVG)是一种严重致盲的难治性疾病。本综述的目的是提供有关其基础和临床方面的详细信息,以便我们能合理地对其进行管理。因此,将对其病因、发病机制和病理、早期诊断方法及管理进行讨论。为预防或减少NVG导致的视力丧失程度,首要的是对其发生高度怀疑。导致NVG发生的最常见疾病是缺血性视网膜中央静脉阻塞(CRVO)、糖尿病视网膜病变和眼部缺血综合征。在管理策略中,首要任务应是通过对致病疾病进行适当管理来试图预防其发生。如果NVG已经发生,早期诊断对于减少视力丧失程度至关重要。NVG的管理主要包括通过药物和/或手术手段控制高眼压,以尽量减少视力丧失。尽管多年来提倡多种药物和手术选择并宣称有效果,但目前对于大多数患者,我们仍然没有一种令人满意的治疗NVG并预防视力丧失的方法。本综述讨论了各种提倡治疗方法的利弊。