NEOVASCULAR GLAUCOMA AFTER CAROTID ENDARTERECTOMY

The authors examined a patient who had neovascular glaucoma (NVG) shor tly after ipsilateral carotid endarterectomy and followed the patient' s clinical course. The authors speculate that the sudden reperfusion a fter endarterectomy that occurs in patients with combined central reti nal artery occlusion and carotid occlusive disease may enhance the cir culation of preformed angiogenesis factors, leading to the development of neovascularization, The authors recommend frequent and careful sur veillance of patients with central retinal artery occlusion associated with carotid occlusive disease if ipsilateral carotid endarterectomy is performed, [Ophthalmic Surg Lasers 1996;27:881-884.] Numerous autho rs have reported the occurrence of neovascular glaucoma (NVG) resultin g from carotid occlusive disease.(1-4) NVG is only one manifestation o f carotid occlusive disease and a spectrum exists that includes transi ent ischemic attacks, venous stasis retinopathy, and ocular ischemic s yndrome.(5-10) The occurrence of NVG has been rarely reported after ca rotid endarterectomy.(11) We-treated a patient with carotid artery occ lusive disease who sustained a central retinal artery occlusion and la ter had fulminant NVG Shortly after ipsilateral carotid endarterectomy . The pathophysiology of NVG following carotid endarterectomy in this setting is unclear and may represent a unique entity.