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SCOPING: A Multidisciplinary Treatment Protocol for Neovascular Glaucoma with Completely Open or Partially Open
Nikita Mokhashi1, Jacob Kanter2, Rahul Komati3
1Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|December 8, 2025
Summary
The SCOPING protocol effectively treats neovascular glaucoma (NVG) by suppressing neovascularization and controlling intraocular pressure. This approach helps salvage the conventional outflow pathway in patients with open angles, reducing the need for surgery in some cases.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Neovascularization Studies
Background:
- Neovascular glaucoma (NVG) presents a significant challenge in ophthalmology.
- Established treatments focus on reducing neovascular drive and intraocular pressure (IOP).
- A standardized protocol for NVG management was lacking.
Purpose of the Study:
- To evaluate the efficacy of the Salvaging the Conventional Outflow Pathway in Neovascular Glaucoma (SCOPING) protocol.
- To suppress neovascular drive and control IOP in eyes with NVG.
- To assess the potential for medical or surgical salvage of the anterior chamber angle.
Main Methods:
- A multidisciplinary treatment protocol (SCOPING) was applied to 9 eyes with NVG.
- Treatment involved serial monthly intravitreal bevacizumab injections.
- Pan-retinal photocoagulation was interspersed with injections.
Main Results:
- Five eyes with completely open angles achieved or maintained physiologic IOP without surgery.
- Three of four eyes with partially open angles required subsequent IOP-lowering surgery.
- No recurrence of anterior segment neovascularization was observed during the protocol.
Conclusions:
- The SCOPING protocol may successfully salvage the conventional outflow pathway in NVG patients.
- It offers a structured approach for managing NVG, particularly in eyes with open or partially open angles.
- This protocol provides a valuable tool for glaucoma specialists treating neovascular glaucoma.
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