In patients with central retinal artery occlusion, the development of neovascularization — affecting the iris, retina, or anterior chamber angle — is a serious complication requiring prompt recognition and a targeted treatment approach.

Clinical Situation

This protocol addresses the specific setting of neovascularization of the retina, iris, or anterior chamber angle occurring in the context of retinal artery occlusion. Neovascularization of the iris carries particular urgency, especially when anterior segment involvement progresses to neovascular glaucoma.

Treatment Approach

Management in this setting centers on panretinal photocoagulation (PRP) surgery. Depending on the clinical picture — in particular the extent and location of neovascularization — intravitreal therapy may also be part of the approach. The complete protocol, including the criteria for selecting and sequencing interventions, is available in full below.

References

DOI: 10.1016/j.ophtha.2024.12.024

Panretinal photocoagulation (PRP) treatment is recommended for patients who develop iris or retinal neovascularization.
Panretinal photocoagulation surgery (PRP) with or without anti-vascular endothelial growth factor (VEGF) therapy is recommended for patients who develop neovascularization of the retina, iris, or angle.
However, in the presence of anterior segment neovascularization, and especially when neovascular glaucoma occurs, prompt PRP or prompt anti-VEGF therapy with prompt or delayed PRP should be performed.

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Treatment of Central Retinal Artery Occlusion with Neovascularization of the Iris, Retina, or Anterior Chamber Angle

References