Kanter Jacob A, Amin Pathik, Komati Rahul, Mackin Anna G, Dao David, Shaw Lincoln T, Skondra Dimitra, Qiu Mary
Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL, USA.
Am J Ophthalmol Case Rep. 2022 Jul 31;28:101668. doi: 10.1016/j.ajoc.2022.101668. eCollection 2022 Dec.
To report a case of acute neovascular glaucoma with partial synechial angle closure secondary to central retinal vein occlusion that underwent gonioscopy-assisted transluminal trabeculotomy as well as near-monthly anti-vascular endothelial growth factor (VEGF) injections and panretinal photocoagulation (PRP) treatments.
Nine months after GATT, the patient had achieved intraocular pressure control on no medications. However, she was lost to follow up for 4 months and received no anti-VEGF or PRP during that time; she re-presented with acute NVG and complete synechial closure, and ultimately underwent aqueous shunt implantation.
To our knowledge, this is the first reported attempt of an angle surgery to successfully restore aqueous outflow through the conventional outflow pathway in an eye with acute NVG and partial synechial angle closure. We posit that this can be an effective approach to achieve IOP control in NVG with at least partially open angles, as long as sufficient anti-neovascular treatments are administered until the underlying neovascular drive achieves quiescence.
报告1例继发于视网膜中央静脉阻塞的急性新生血管性青光眼伴部分虹膜周边前粘连病例，该病例接受了前房角镜辅助腔内小梁切开术以及近每月1次的抗血管内皮生长因子（VEGF）注射和全视网膜光凝（PRP）治疗。
小梁切开术辅助腔内小梁切开术后9个月，患者未使用任何药物眼压得到控制。然而，她失访了4个月，在此期间未接受抗VEGF或PRP治疗；她再次出现急性新生血管性青光眼和完全虹膜周边前粘连，最终接受了房水引流植入术。
据我们所知，这是首次报道的在急性新生血管性青光眼伴部分虹膜周边前粘连的眼中，通过角手术成功恢复经传统房水流出途径的房水流出的尝试。我们认为，只要给予足够的抗新生血管治疗直至潜在的新生血管驱动静止，这可以是一种在至少部分房角开放的新生血管性青光眼中实现眼压控制的有效方法。
