Chou Yu-Bai, Chang Hsin-Ho, Chiu Hsun-I, Chou Yiing-Jenq, Pu Christy
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ophthalmic Epidemiol. 2025 Apr;32(2):204-212. doi: 10.1080/09286586.2024.2370260. Epub 2024 Jul 31.
To explore potential risk factors for the development of neovascular glaucoma (NVG) in central retinal vein occlusion (CRVO) over a two-year intensive follow-up period.
This study reviewed 1545 patients with CRVO between 2005 and 2019 at Taipei Veterans General Hospital. Inclusion was restricted to (1) patients with acute CRVO within 3 months; (2) patients with ocular neovascularization at initial presentation (3) patients had not received any treatment at the time of CRVO; (4) at least bimonthly follow-up schedule over the course of 2 years. The included patients were screened for potential risk factors for developing NVG and assessed with Kaplan-Meier survival analysis and Cox regression model.
Among the included 123 patients, the cumulative probability of developing NVG was 26.8% (33/123 cases) in overall follow-up period. The mean interval between the onset of CRVO and NVG was 507 days. Neither macular edema nor central macular thickness at baseline was correlated with the development of NVG ( =.104 and .25, respectively). Patients with diabetes mellitus (DM), older age, and poor vision independently played significant risk factors for developing NVG after controlling other covariates. ( =.034, .001, and .013, respectively).
Patients presenting with CRVO who have comorbidities such as DM, older age, and worse VA warrant closer attention and intensive follow-up for the development of NVG. Additionally, the statistical analysis indicated that the presence of macular edema, increased central macular thickness, CV events, history of glaucoma, and early PRP within 3 months had no significant impact on the likelihood of developing NVG.
在为期两年的密集随访期内，探讨视网膜中央静脉阻塞（CRVO）患者发生新生血管性青光眼（NVG）的潜在危险因素。
本研究回顾了2005年至2019年台北荣民总医院收治的1545例CRVO患者。纳入标准限定为：（1）发病3个月内的急性CRVO患者；（2）初诊时有眼部新生血管形成的患者；（3）CRVO发病时未接受任何治疗的患者；（4）在2年的随访期间至少每两个月随访一次。对纳入的患者进行了NVG发生潜在危险因素的筛查，并采用Kaplan-Meier生存分析和Cox回归模型进行评估。
在纳入的123例患者中，总体随访期内发生NVG的累积概率为26.8%（33/123例）。CRVO发病至NVG的平均间隔时间为507天。基线时黄斑水肿和中心黄斑厚度均与NVG的发生无关（分别为P = 0.104和P = 0.25）。在控制其他协变量后，糖尿病（DM）患者、年龄较大和视力较差是发生NVG的独立显著危险因素（分别为P = 0.034、P = 0.001和P = 0.013）。
合并DM、年龄较大和视力较差等合并症的CRVO患者，发生NVG时需要密切关注并进行密集随访。此外，统计分析表明，黄斑水肿、中心黄斑厚度增加、心血管事件、青光眼病史以及发病3个月内早期进行全视网膜光凝（PRP）对发生NVG的可能性没有显著影响。
