Familial Exudative Vitreoretinopathy and Glaucoma: Observations, Insights, and Management Strategies

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We report two cases of bilateral severe familial exudative vitreoretinopathy (FEVR) presenting with bilateral angle closure glaucoma, with evidence of neovascularization in one eye of each case. Both cases displayed bilateral disc dragging with evidence of avascular retinae on fundus fluorescein angiography. Retinal laser photocoagulation and antivascular endothelial growth factor injections provided satisfactory regression of the neovascularization. Medical management of glaucoma was administered to both patients. Lens aspiration with posterior chamber intraocular lens implantation was performed for one eye of each patient. It helped in clearing media as well as in increasing anterior chamber depth, helping in indirect control of intraocular pressure. Although the primary pathology of FEVR lies in the retina, a comprehensive glaucoma screening is essential. We conclude that neovascular glaucoma albeit uncommon in FEVR, may be the presenting feature in advanced unlasered cases, and should be specifically looked for.

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