Incidence and Risk Factors Associated With the Development of Neovascular Glaucoma Following a Diagnosis of Proliferative Diabetic Retinopathy or Retinal Vein Occlusion

Background and Objective: This study aimed to evaluate cumulative incidence and risk factors for neovascular glaucoma (NVG) in patients with proliferative diabetic retinopathy (PDR), central retinal vein occlusion (CRVO), or branch retinal vein occlusion (BRVO). Patients and Methods: A retrospective cohort study using an aggregated, de-identified electronic health record platform (TriNetX), with data from 60+ health care organizations, identified patients with ICD-10 encounter diagnoses for PDR, CRVO, or BRVO and subsequent NVG. NVG cumulative incidence was calculated at 1 day, 1 month, and 3 months post-diagnosis. Risk factors were evaluated after propensity score matching. Incidence (%), relative risk, and 95% CI were reported. Results: Neovascular glaucoma developed in 8.8% of PDR ( n = 14,937), 11.6% of CRVO ( n = 6,302), and 4.4% of BRVO ( n = 2,253) cases. Risk was significantly higher for male patients, age ≥ 70, Black or Hispanic, or with primary open angle glaucoma, hypertension, or diabetes mellitus. Conclusion: Neovascular glaucoma is a common early complication of retinal vascular disease. Several demographic and systemic factors may warrant closer monitoring to prevent vision loss.