Neovascular glaucoma (NVG) is a severe, vision-threatening secondary glaucoma associated with ocular ischemia and systemic vascular disease. Whether NVG also serves as a marker of systemic vascular risk remains unclear. In this retrospective, multicenter cohort study, adults with NVG were identified from a global electronic health record network and 1:1 propensity score matched to controls, accounting for demographics, comorbidities, medications, and healthcare utilization. Follow-up was up to 10 years. Primary outcomes were all-cause mortality, myocardial infarction, stroke, cardiac arrest, and three-point major adverse cardiovascular events (3P-MACE). Sensitivity analyses compared NVG with primary open-angle glaucoma (POAG) and examined subgroups with proliferative diabetic retinopathy, retinal vein occlusion, or ocular ischemic syndrome. Among 17,020 matched pairs, NVG was associated with higher risks of all-cause mortality (HR 1.70, 95% CI 1.60-1.81), myocardial infarction (HR 1.53, 95% CI 1.40-1.67), cardiac arrest (HR 1.57, 95% CI 1.36-1.82), stroke (HR 1.62, 95% CI 1.48-1.79), and 3P-MACE (HR 1.59, 95% CI 1.51-1.68). Findings were consistent across sensitivity and ischemic retinal subgroups. NVG is associated with increased long-term mortality and cardiovascular events, suggesting that its occurrence may identify patients with higher systemic vascular risks and supporting the need for proactive cardiovascular assessment.
Eshel et al. (Sun,) studied this question.