歯学ジャーナル
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概要

Retinal Photocoagulation Density in the Treatment of Neovascular Glaucoma due to Diabetic Retinopathy

Teruhiko Hamanaka, Takayasu Omata, Noriko Akabane, Toshihiro Yajima and Nobuo Ishida

Purpose: The risk factors for pan-retinal photocoagulation (PRP) failure and the efficacy of achieving a PRP burn density of ≥ 40% in the mid-periphery against diabetic neovascular glaucoma (NVG) were retrospectively evaluated.
Methods: All eyes were treated in order to exceed more than 40% PRP density by fluorescein fundus angiography before and after PRP. Risk factors for failed IOP control (≤22 mmHg or baseline) were evaluated by dividing into two groups; eyes received previous retinal photocoagulation (RP) before NVG (group I) and eyes with no RP before NVG (group II).
Results: Thirty one eyes of 25 patients were used (group I: 12 eyes, group II: 19 eyes).RP density before NVG in all eyes in group I was less than 40%. Risk factors for failed IOP control were prolonged PRP treatment of more than 12 months in group I (p=0.00053), and higher IOP at the diagnosis of NVG (p=0.01157), preexisting glaucoma or ocular hypertension (OH) (p=0.04664) and the persistence of optic disc neovascularization (NVD) in group II (p=0.01766).
Conclusion: Eyes with RP density of less than 40% may have a risk for later development of NVG. The prompt initiation of PRP, a PRP burn density of greater than 40%, and the completion of PRP within 6 months are strongly recommended for the treatment of NVG. Special care should be taken in NVG-affected eyes with small pupils, preexisting glaucoma or OH, or persistent NVD as well as those that are subjected to PRP for more than 12 months.