Gonioscopy-assisted transluminal trabeculotomy in neovascular glaucoma: Salvaging the conventional outflow pathway

Jacob A. Kanter, Pathik Amin, Rahul Komati, Anna G. Mackin, David Dao, Lincoln T. Shaw, Dimitra Skondra, Mary Qiu

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To report a case of acute neovascular glaucoma with partial synechial angle closure secondary to central retinal vein occlusion that underwent gonioscopy-assisted transluminal trabeculotomy as well as near-monthly anti-vascular endothelial growth factor (VEGF) injections and panretinal photocoagulation (PRP) treatments. Observations: Nine months after GATT, the patient had achieved intraocular pressure control on no medications. However, she was lost to follow up for 4 months and received no anti-VEGF or PRP during that time; she re-presented with acute NVG and complete synechial closure, and ultimately underwent aqueous shunt implantation. Conclusions and Importance: To our knowledge, this is the first reported attempt of an ab interno angle surgery to successfully restore aqueous outflow through the conventional outflow pathway in an eye with acute NVG and partial synechial angle closure. We posit that this can be an effective approach to achieve IOP control in NVG with at least partially open angles, as long as sufficient anti-neovascular treatments are administered until the underlying neovascular drive achieves quiescence.

Original languageEnglish (US)
Article number101668
JournalAmerican Journal of Ophthalmology Case Reports
Volume28
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • Gonioscopy-assisted transluminal trabeculotomy
  • Neovascular glaucoma
  • Peripheral anterior synechiae

ASJC Scopus subject areas

  • Ophthalmology

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