Abstract
PURPOSE: To characterize the impact of neovascular glaucoma (NVG) and its underlying etiology on mortality and determine the association between NVG and cause of death. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 210 subjects with NVG were included in the descriptive study. Of the 210 subjects, 132 with a definite date of NVG onset were included in the survival analysis. METHODS: Patients with NVG seen at our tertiary care center from 2015-2016 were identified. Demographic information, underlying etiology, and medical conditions were documented. The Centers for Disease Control and Prevention National Death Index (CDC NDI) was used to designate if subjects were alive on December 31, 2021, and to determine the primary cause of death. Kaplan-Meier and Cox proportional hazard regression analyses were performed on subjects with a definitive date of NVG onset. RESULTS: Of the 210 subjects, 32% were deceased by December 31, 2021. The commonest diagnosis was proliferative diabetic retinopathy (PDR) (57%), followed by central retinal vein occlusion (CRVO) (29%). Of 132 subjects included in the Kaplan-Meier survival analysis, the mean survival time was 154 ± 15 months (95% CI: 125-183). Cox regression analysis demonstrated that older age (HR 1.03, 95% CI: 1.004-1.06, P = 0.02) and central retinal artery occlusion (CRAO) (HR: 4.63, 95% CI: 1.7-12.44, P = 0.002) were associated with poorer survival. CONCLUSIONS: Increasing age and CRAO-related NVG (compared to CRVO-unrelated) were important predictors of increased mortality. Our results highlight the need for aggressive management of underlying systemic co-morbid conditions contributing to early mortality in patients with NVG.