Kerala Journal of Ophthalmology

: 2019  |  Volume : 31  |  Issue : 1  |  Page : 81-

Neovascular glaucoma

KR Reesha 
 Little Flower Hospital and Research Centre, Angamaly, Kerala, India

Correspondence Address:
K R Reesha
Little Flower Hospital and Research Centre, Angamaly, Kerala

How to cite this article:
Reesha K R. Neovascular glaucoma.Kerala J Ophthalmol 2019;31:81-81

How to cite this URL:
Reesha K R. Neovascular glaucoma. Kerala J Ophthalmol [serial online] 2019 [cited 2020 May 31 ];31:81-81
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Full Text

Dear Sir,

I would like to congratulate the authors for doing excellent work on “Neovascular glaucoma (NVG)” in the last issue of KJO by Saikumar et al. The authors have clearly highlighted the various aspects of this subject including the management. Is there any role for intracameral anti-vascular endothelial growth factor (VEGF) in NVG?

As mentioned clearly in the article, VEGF plays a major part in mediating active intraocular neovascularization in patients with ischemic retinal diseases. VEGF and insulin growth-1 factors are produced locally in the human eye by a variety of cells, including Mueller cells, retinal pigment epithelial cells, retinal capillary pericytes, endothelial cells, and ganglion cells. VEGF is sufficient to produce iris neovascularization in a nonhuman primate.[1] Neovascularization was consistent with the increase of insulin growth-1 factor and induction of VEGF expression in the retinal glial cells. Insulin growth-1 factor accumulated in aqueous humor may cause rubeosis iridis, and subsequently, adhesions between the cornea and iris may block aqueous humor drainage.[2] The concentration of VEGF can decline after the regression of iris neovessels.[3] The nonpigmented ciliary epithelium is an important site of VEGF synthesis in patients with NVG. In fact, a recent study considered the ciliary epithelium as an additional focus of treatment in the management of NVG, especially in eyes that were not responsive to panretinal photocoagulation.[4]

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1Tolentino MJ, Miller JW, Gragoudas ES, Chatzistefanou K, Ferrara N, Adamis AP, et al. Vascular endothelial growth factor is sufficient to produce iris neovascularization and neovascular glaucoma in a nonhuman primate. Arch Ophthalmol 1996;114:964-70.
2Ruberte J, Ayuso E, Navarro M, Carretero A, Nacher V, Haurigot V, et al. Increased ocular levels of IGF-1 in transgenic mice lead to diabetes-like eye disease. J Clin Invest 2004;113:1149-57.
3Chen T, Zeng SQ, Lu YY, Huang LY, Dai H. The change of the level of the vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma before and after anterior retinal cryotherapy. Zhonghua Yan Ke Za Zhi 2007;43:622-5.
4Chalam KV, Brar VS, Murthy RK. Human ciliary epithelium as a source of synthesis and secretion of vascular endothelial growth factor in neovascular glaucoma. JAMA Ophthalmol 2014;132:1350-4.