Approach to a case of Neovascular Glaucoma.pptx

This PPT is about a case scenario of Neovascular Glaucoma

1. Case scenario on Neovascular Glaucoma Presented by:- Ranjita Amanatya VIMSAR, BURLA

2. A 60 years old diabetic male with CRVO develops:- Painful blind eye (R.E.) IOP:- 46mmHg Neovascularization of iris & angle

3. Provisional diagnosis:- (R.E.) Neovascular glaucoma with angle closure component

4. HISTORY Past history Surgical history

5. OCULAR EXAMINATIONS (R.E.) Visual acuity (R.E):- PL (Absent) Slit-lamp examination Gonioscopy USG B-SCAN Doppler IOP(R.E.):- 46mmHg

6. Angle- closure glaucoma stage Stroma of the iris become flatened , with a smooth glistening appearance. Ectropion uvea is frequently present, and pupil often dilated & pulled anteriorly from lens. Anterior chamber angle, the contracture leads to formation of peripheral anterior synechia with eventual total synechial closure of the angle. Slit-lamp examination (R.E.)

7. Angle- closure glaucoma stage of NVG Contracture of fibrovascular membrane, causing:- Corectopia , Ectropion uvea, Flattening of iris & Peripheral anterior synechiae

8. Gonioscopy (R.E.)

9. Gonioscopy (R.E.)

10. USG B-SCAN (R.E.) D iagnostic tool when visualization of the posterior segment is impaired, such as due to vitreous hemorrhage or other media opacities.  To assess the status of the retina, vitreous, and other posterior structures ( I dentifying underlying causes of NVG) like:- R etinal detachment

11. Colour Doppler Imaging (R.E.) CDI aids in diagnosing and monitoring conditions like diabetic retinopathy, central retinal vein occlusion, and neovascular glaucoma.

12. SYSTEMIC WORK-UP RBS Fasting Blood Glucose PPBS HbA1C Blood Pressure Complete hemogram with peripheral smear Lipid profile ESR C-reactive protein Serum angiotensin converting enzyme Carotid Doppler Scan D iabetes CRVO

13. TREATMENT TSCPC Thermotherapy Enucleation TSCPC > Enucleation Medical therapy is ineffective and surgical intervention is required.

14. TSCPC Transscleral Nd:YAG (neodymium- doped ytrium aluminum garnet) cyclophotocoagulation Diode laser cyclophotocoagulation Laser cyclodestructive procedures include >

15. TSCPC

16. PROGNOSIS Guarded prognosis Success depends on prevention & early t/t.