Korean J Ophthalmol.  2017 Aug;31(4):343-350. 10.3341/kjo.2016.0067.

Clinical Features of Ocular Ischemic Syndrome and Risk Factors for Neovascular Glaucoma

• Kim YH
• Sung MS
• Park SW

• KMID: 2385584
• DOI: http://doi.org/10.3341/kjo.2016.0067

Abstract

PURPOSE
We aimed to examine the clinical features and prognosis of ocular ischemic syndrome and to investigate the risk factors for the development of neovascular glaucoma (NVG).
METHODS
The medical records from 25 patients (25 eyes) who were diagnosed with ocular ischemic syndrome were retrospectively analyzed. We recorded the length of time between symptom onset and diagnosis, visual acuity, intraocular pressure, clinical findings of the anterior and posterior segments of the eye, fluorescein angiography, systemic diseases, smoking history, and the extent of any ipsilateral carotid artery stenosis. The risk factors for NVG in patients with ocular ischemic syndrome were investigated.
RESULTS
The mean age was 67.9 ± 12.5 years, and 21 men and 4 women were included in this study. At initial examination, the mean logarithm of the minimum angle of resolution (logMAR) was 2.02 ± 1.26, and the mean intraocular pressure was 21.0 ± 10.3 mmHg. Among 25 eyes of the 25 patients, NVG occurred in 17 eyes after a mean period of 12.6 ± 14.0 months. The length of time between symptom onset and diagnosis (p = 0.025) and the extent of ipsilateral carotid artery stenosis (p = 0.032) were identified as significant risk factors for NVG. At the final follow-up, the mean logMAR visual acuity was 3.13 ± 1.24, showing a poor prognosis regardless of whether NVG occurred.
CONCLUSIONS
Overall, the prognosis for ocular ischemic syndrome is very poor. The risk of NVG increases with the length of time between symptom onset and diagnosis, as well as with the severity of ipsilateral carotid artery stenosis.

Keyword

Carotid stenosis; Glaucoma; Neovascular; Ocular ischemic syndrome; Risk factors

MeSH Terms

Carotid Stenosis
Diagnosis
Female
Fluorescein Angiography
Follow-Up Studies
Glaucoma
Glaucoma, Neovascular*
Humans
Intraocular Pressure
Male
Medical Records
Prognosis
Retrospective Studies
Risk Factors*
Smoke
Smoking
Visual Acuity
Smoke

Figure

• 

  Fig. 1 Comparison of ocular manifestations in patients with and without neovascular glaucoma (NVG). Only the proportion of neovascularization of the iris (NVI) was found to be significantly higher in the NVG group. *Fisher exact test.

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