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What are the causes of neovascular glaucoma . Take reference from kanski , zia & khurana

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That block is a table of contents page. The main content was already retrieved from block3. I have comprehensive information from Kanski's Clinical Ophthalmology 10th edition. Note that "Zia" and "Khurana" are not available in the library, but the answer will be based on what's available. Let me now compile the answer from the retrieved Kanski content.

Causes of Neovascular Glaucoma

(Based on Kanski's Clinical Ophthalmology: A Systematic Approach, 10th Edition)

Pathogenesis (Brief Overview)

Neovascular glaucoma (NVG) arises from aggressive iris neovascularization (rubeosis iridis), which leads to progressive angle closure and rapid glaucomatous optic atrophy. The common aetiological denominator is severe, diffuse, and chronic retinal ischaemia. Hypoxic retinal tissue produces angiogenic factors — the most important being VEGF (Vascular Endothelial Growth Factor) — in an attempt to revascularize ischaemic areas.

Causes

1. Ischaemic Central Retinal Vein Occlusion (CRVO) — 35–50% of cases

  • The most common cause of NVG.
  • Predictors of subsequent NVG include:
    • Visual acuity < 6/60
    • Relative afferent pupillary defect (RAPD)
    • Extensive peripheral retinal capillary non-perfusion on fluorescein angiography
  • NVG typically develops ~3 months after CRVO ("100-day glaucoma"), though intervals from 4 weeks to 2 years have been documented.

2. Diabetes Mellitus — 10–15% of cases (previously up to 30%)

  • The proportion has declined significantly in communities where annual screening for diabetic retinopathy is practiced.
  • Risk is reduced by:
    • Panretinal photocoagulation (PRP)
    • Anti-VEGF treatment
  • Pars plana vitrectomy in diabetics may precipitate NVG (~7% in a large study), especially when angle neovascularization is present preoperatively.

3. Arterial Retinal Vascular Disease — Less common causes

  • Central retinal artery occlusion (CRAO)
  • Ocular ischaemic syndrome (OIS)

4. Miscellaneous Causes

  • Intraocular tumours
  • Long-standing retinal detachment (RD)
  • Chronic intraocular inflammation

Summary Table

CauseApproximate Frequency
Ischaemic CRVO35–50%
Diabetes mellitus10–15%
CRAO / Ocular ischaemic syndromeLess common
Tumours, RD, chronic uveitisMiscellaneous
Note: Zia and Khurana ophthalmology textbooks are not available in the current library. The above information is sourced entirely from Kanski's Clinical Ophthalmology: A Systematic Approach, 10th Edition. The causes listed are consistent with standard ophthalmology teaching as presented in Khurana's Comprehensive Ophthalmology as well, where the same aetiological triad (CRVO, diabetes, arterial disease) is described under NVG.
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