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Current management of glaucoma and vascular occlusive disease

Aref, Ahmad A.

Current Opinion in Ophthalmology: March 2016 - Volume 27 - Issue 2 - p 140–145
doi: 10.1097/ICU.0000000000000239
GLAUCOMA: Edited by Donald L. Budenz

Purpose of review This article summarizes recent findings pertaining to advancements in the treatment of glaucomas secondary to vascular occlusive disease to maximize visual outcomes.

Recent findings Retinal ischemia leads to a local increase in transcription of proteins responsible for aberrant angiogenesis and subsequent neovascular glaucoma. Antivascular endothelial growth factor (VEGF) therapy is helpful in the management of this condition. Although bevacizumab and ranibizumab offer relatively short-term effects, preliminary studies suggest that aflibercept may allow for longer term treatment. Preoperative anti-VEGF injection therapy improves outcomes after trabeculectomy and glaucoma drainage implant surgeries. The treatments for vascular occlusive disease may lead to intraocular pressure elevation and subsequent glaucoma. Aflibercept appears to be a safer agent in this regard.

Summary Prompt diagnosis and management of glaucomas associated with vascular occlusive disease are required to allow for the best possible outcome. Novel anti-VEGF agents, particularly aflibercept, should be strongly considered in the management of these conditions.

Illinois Eye and Ear Infirmary, University of Illinois College of Medicine, Chicago, Illinois, USA

Correspondence to Ahmad A. Aref, MD, Illinois Eye and Ear Infirmary, University of Illinois College of Medicine, 1855 W. Taylor St., M/C 648, Suite 3.171, Chicago, IL 60612, USA. Tel: +1 312 996 7030; fax: +1 312 413 8574; e-mail:

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