A Case of Neovascular Glaucoma Secondary to Ocular Ischemia
James Paul S. Gomez, MD
Amadeo A. Veloso, MD
Edgar U. Leuenberger, MD
Asian Eye Institute, Makati, Metro Manila
Corresponding Author: James Paul S. Gomez, MD
Clinic Address: 8-10th flr, Phinma Plaza Building, Plaza Drive, Makati, Metro Manila
Contact Number: (02) 8-898-2020
Email Address: jsgomez@asianeyeinstitute.com
Disclosure: The authors report no financial interests or support.
ABSTRACT
Objective: To present a case of neovascular glaucoma secondary to ocular ischemic syndrome following an uncomplicated phacoemulsification.
Methods: This is a case description of a 74-year-old male who developed blurred vision and increased intraocular pressure (IOP) two months after an uncomplicated phacoemulsification cataract surgery with posterior chamber lens implantation of the left eye. There was iris neovascularization with absence of retinal dot/blot hemorrhages or neovascularization. The fluorescein angiogram (FA) showed delayed choroidal fluorescence and arteriovenous time. IOP-lowering medications and intravitreal injection of aflibercept were given. Carotid doppler test showed 70% stenosis of the ipsilateral artery but a subsequent magnetic resonance angiography (MRA) did not show evidence of significant stenosis.
Results: At his last consultation, visual acuity improved to counting fingers. IOP was maintained at 12 mmHg with one anti-glaucoma medication.
Conclusion: Ocular ischemia can confound the outcome of an uncomplicated cataract surgery. Doppler scans are usually chosen as the first-line exam for those suspected of carotid stenosis but, at times, may have contradictory results with MRA.
Keywords: neovascular glaucoma, phacoemulsification, ocular ischemic syndrome