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Lee, Kim, Kim, Shin, Kim, Lee, and Lee: Prognostic Factors of Neovascular Glaucoma in Eyes with Treated Proliferative Diabetic Retinopathy
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(4): 415-419.

Published online: 14 April 2017

DOI: https://doi.org/10.3341/jkos.2017.58.4.415

Prognostic Factors of Neovascular Glaucoma in Eyes with Treated Proliferative Diabetic Retinopathy

Ji Hyun Lee, MD, Eun Yeong Kim, MD, Tai Kyong Kim, MD, Hye Young Shin, MD, Su Young Kim, MD, PhD, Young Chun Lee, MD, PhD, Mee Yon Lee, MD, PhD

Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.

Address reprint requests to Mee Yon Lee, MD, PhD. Department of Ophthalmology, The Catholic University of Korea Uijeongbu St. Mary's Hospital, #271 Cheonbo-ro, Uijeongbu 11765, Korea. Tel: 82-31-820-3022, Fax: 82-31-847-3418, deenie@daum.net

Received 8 December 2016       Revised 15 February 2017       Accepted 27 March 2017

©2017 The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the factors that are significant in progression to neovascular glaucoma in patients with proliferative diabetic retinopathy.

Methods

In this retrospective analysis, we reviewed the medical records of 52 patients who were first diagnosed with proliferative diabetic retinopathy from March 2014 to March 2016. We compared diabetes mellitus period, HbA1c, chronic diseases such as hypertension, hyperlipidemia, and kidney disease, insulin treatments, blood urea nitrogen, blood creatinine, glomerular filtration rate, urine albumin, dialysis, corrected visual acuity at the first visit, traction membrane sign of the retina at the first visit, vitreous hemorrhage and preretinal hemorrhage in each group and then investigated the prognostic factors of neovascular glaucoma.

Results

A total of 52 patients were included in the investigation, 12 patients (23.08%) were diagnosed with iris neovascularization and 4 patients (7.69%) developed neovascular glaucoma. The patients without iris neovascularization were defined as Group I, those with iris neovascularization as Group II, and those with neovascular glaucoma as Group III. The diabetes mellitus period was significantly longer in Group II (10.88 ± 7.14 years) and in Group III (11.75 ± 8.61 years) than Group I (8.30 ± 5.25 years) (p-value 0.41, 0.032, respectively). The HbA1c level was 9.59 ± 2.23 in Group II and 9.27 ± 2.54 in Group I. There was no significant difference between the two groups (p = 0.721). However, HbA1c was significantly higher in Group III (11.55 ± 0.21) than Group I (p-value 0.048).

Conclusions

A long diabetes mellitus period and high HbA1c level have a significant effect on the progression to neovascular glaucoma in patients with proliferative diabetic retinopathy. This information could be useful for predicting and preventing the prognosis of patients.

Keywords: Diabetes mellitus, Hb1AC, Neovascular glaucoma, Proliferative diabetic retinopathy

Figures and Tables

Table 1

Demographics of three groups

jkos-58-415-i001

Values are presented as mean ± SD unless otherwise indicated. ‘Group I’ means ‘Control Group’, ‘Group II’ means ‘patients who developed neovascular iridis’, and ‘Group III’ means ‘Patients who developed neovascular glaucoma’.

SD = standard deviation; DM = diabetic mellitus; BUN = blood urea nitrogen; Cr = Creatinine; GFR = glomerular filtration rate.

*Statistically significant; †Comparison between Group I and Group II (Student t-test for continuous variables, chai-square test for discontinuous variables); ‡Comparison between Group I and Group III (Mann-Whitney U-test for continuous variables, chai-square test for discontinuous variables).

Table 2

Demographics of three groups according to ophthalmologic examination

jkos-58-415-i002

Values are presented as mean ± SD or n (%) unless otherwise indicated. ‘Group I’ means ‘Control Group’, ‘Group II’ means ‘Patients who developed neovascular iridis’ and ‘Group III’ means ‘Patients who developed neovascular glaucoma’.

SD = standard deviation; BCVA = best corrected visual acuity.

*Comparison between Group I and Group II (Student t-test for continuous variables, chai-square test for discontinuous variables); †Comparison between Group I and Group III (Mann-Whitney U-test for continuous variables, chai-square test for discontinuous variables).

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