Treatment modalities and trends for hospitalized patients with neovascular glaucoma: A retrospective study of 10 years.

Abstract

To analyze the treatment modalities and trends for neovascular glaucoma (NVG) over the past 10 years, we conducted a retrospective analysis at Zhongshan Ophthalmic Center on 1331 NVG inpatients who received 1459 treatments for 1383 eyes between January 1, 2012, and December 31, 2021. Over time, we observed a progressive annual increase in both the number of patients and the volume of surgeries for NVG, with an annual percentage change (APC) of 10.23 % (95 % confidence interval [CI]: 5.5-15.2 %, P = 0.001) and 11.59 % (95 % CI: 6.6-16.9 %, P = 0.001), respectively. Drainage valve implantation (46.88 %), cyclodestructive procedures (22.55 %) and trabeculectomy (6.24 %) were the three most commonly selected treatment options. The frequency of drainage valve implantation (APC = 6.59 %, 95 % CI = 0.9-12.6 %, P = 0.028), cyclodestructive procedures (APC = 17.26 %, 95 % CI = 9.3-25.8 %, P = 0.001) and trabeculectomy (APC = 21.93 %, 95 % CI = 1.6-46.3 %, P = 0.036) increased. The proportion of drainage valve implantation gradually decreased (APC = -4.48 %, 95 % CI = -8.6 to -0.2 %, P = 0.042), while that of cyclodestructive procedures increased (APC = 5.08 %, 95 % CI = 0.6-9.8 %, P = 0.042), with no significant alteration observed in the proportion of trabeculectomy (APC = 9.26 %, 95 % CI = -8.8-30.9 %, P = 0.290). Over the course of the study, both the cases of NVG and the volume of related surgeries escalated year by year. Among the three most frequently employed procedures-drainage valve implantation, cyclodestructive procedures and trabeculectomy-annual frequency trends revealed an increase in drainage valve implantation alongside a decreasing proportion, while cyclodestructive procedures exhibited a rising trend in both frequency and proportion; simultaneously, trabeculectomy showed an increasing frequency without a significant change in its proportion.