Central retinal artery occlusion without underlying chronic ocular ischemic syndrome may lead to neovascular glaucoma

The prevalence and etiology of neovascular glaucoma (NVG) as a complication of central retinal artery occlusion (CRAO) is a debated issue. According to some authors, NVG associated with CRAO always involves underlying chronic ocular ischemic syndrome (COIS) as a primum movens for CRAO. However, we describe 5 cases of NVG following CRAO with no underlying COIS, confirmed by carotid Doppler studies and ultrasound color Doppler imaging (USCDI) of the ophthalmic artery (OA).

We conducted a single-center retrospective analysis of the medical records of 5 consecutive patients who developed NVG following non-arteritic CRAO between July 2010 and July 2014.

Five patients were included. All 5 patients were examined at the emergency room. The 5 patients had normal intraocular pressure and no intraocular neovascularization upon initial examination. They had no hemodynamically significant internal carotid artery stenosis, and the ophthalmic artery USCDI was normal. These 5 patients developed NVG subsequently to the CRAO.

In our patients, carotid Doppler studies and USCDI of the OA ruled out COIS. Thus, COIS did not cause the NVG. CRAO may therefore lead to neovascular glaucoma without underlying COIS.