Neovascular glaucoma: pathophysiology, diagnosis, and contemporary management
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By
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Danyang Yu
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Chaoxiong Cui
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Guanghao Li
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Zhenbao Wang
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May 22, 2026
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Clinical Scorecard: Understanding Neovascular Glaucoma: Mechanisms, Diagnostic Approaches, and Current Treatment Strategies
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Pathologic neovascularization of the iris and anterior chamber angle due to retinal ischemia. |
| Target Population | Patients with ischemic retinal diseases, particularly those with proliferative diabetic retinopathy and ischemic retinal vein occlusion. |
| Care Setting | Ophthalmology clinics and surgical settings. |
Key Highlights
- Diagnosis involves slit-lamp examination, gonioscopy, and multimodal imaging.
- Intravitreal anti-VEGF injections can temporize neovascularization but require additional treatments for long-term management.
Guideline-Based Recommendations
Diagnosis
- Utilize slit-lamp examination and gonioscopy.
- Employ multimodal imaging techniques such as ultrawidefield fluorescein angiography and anterior-segment OCT.
Management
- Administer intravitreal anti-VEGF injections.
- Combine anti-VEGF therapy with panretinal photocoagulation or other ischemia-directed therapies.
Monitoring & Follow-up
- Regularly assess intraocular pressure and visual acuity.
Risks
- High rates of surgical failure and ocular morbidity.
Patient & Prescribing Data
Individuals with neovascular glaucoma secondary to ischemic retinal diseases.
Management requires a combination of antiangiogenic therapies and definitive treatment of underlying retinal ischemia.
Clinical Best Practices
- Implement a multimodal approach for diagnosis and management.
- Prioritize individualized care strategies for each patient.
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