Preliminary clinical analysis of neovascular glaucoma secondary to carotid artery disease

Abstract

Background:  Neovascular glaucoma (NVG) is a rare but severe complication of hypoperfusion retinopathy. Our objective was to analyse the clinical features of NVG secondary to carotid artery atherosclerosis, moyamoya disease and Takayasu arteritis.

Methods:  Thirty‐six cases (36 eyes) with hypoperfusion retinopathy associated with NVG were retrospectively analysed. Each patient had their visual acuity assessed and fundus examined by fundus fluorescein angiography, colour Doppler flow imaging, magnetic resonance angiography, digital subtraction angiography and other techniques.

Results:  Eyes belonging to 30 males and six females were analysed. There were 24 right eyes and 12 left eyes. The ages of these patients ranged 18 to 78 years and the mean age was 40 years. The visual acuities ranged from light perception to 0.8 (decimal notation). Posterior segment manifestations included mid‐peripheral intraretinal haemorrhages and narrowed retinal arteries. All eyes were associated with either an ipsilateral common carotid artery obstruction or a severe bilateral obstruction of the internal carotid arteries.

Conclusions:  The characteristic clinical features are presented during the process of the disease. Degeneration of the ocular fundus was predominantly on one side. The retinal manifestations included mid‐peripheral haemorrhages and dilated retinal veins. High intraocular pressure and excavation and atrophy of the optic disc were common. In the eyes that were examined, neovascularisation was observed in the iris and anterior chamber and various visual field defects were present.

Key words:

• carotid artery stenosis
• eye
• hypoperfusion retinopathy
• neovascular glaucoma
• ocular blood supply