N 2 (199) 2026. P. 22–29

STRESS HYPERGLYCEMIA RATIO AS A PREDICTOR OF THE EFFECTIVENESS OF COMBINED TREATMENT OF NEOVASCULAR GLAUCOMA IN PROLIFERATIVE DIABETIC RETINOPATHY

Yu. V. Barinov, S. A. Rikov, N. V. Konovalova, O. V. Potapchuk,
O. V. Guzun

Kyiv Medical Academy of Postgraduate Education named after P. L. Shupyk, Kyiv, Ukraine ² Odesa National Medical University, Odesa, Ukraine

State Institution “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine”, Odesa, Ukraine

DOI 10.32782/2226-2008-2026-2-3

Objective: To evaluate the prognostic role of the stress hyperglycemia ratio (SHR) and the effectiveness of transscleral laser cyclophotocoagulation (TSCPC) as the first-line treatment of neovascular glaucoma (NVG) in patients with proliferative diabetic retinopathy.

Materials and Methods: A prospective study included 35 eyes with NVG. Clinical and surgical outcomes were assessed according to SHR levels. Cox multivariate regression analysis was used to identify predictors of treatment success.

Results: High SHR was an independent predictor of unfavorable NVG outcomes, increasing the risk of treatment failure 4.1-fold (95% CI: 1.06–16; p = 0.04) and reducing surgical success to 51.8% compared to 82.1% in patients with low SHR (p < 0.01). TSCPC as a preoperative step achieved intraocular pressure control in 87.5% of cases and decreased complication rates to 12.5%, with minimal procedure-related complications (3–3.5%). The combined approach (TSCPC + panretinal laser photocoagulation + anti-VEGF) reduced treatment failure risk 3.7-fold and improved surgical outcomes in patients with high SHR and angle-closure NVG.

Conclusions: High SHR is a significant prognostic marker of poor NVG outcomes. Implementing TSCPC as the first-line intervention in patients with high SHR improves surgical efficacy, reduces complications, and optimizes prognosis.

Keywords: proliferative diabetic retinopathy, neovascular glaucoma, anti-VEGF, surgery, prognosis.

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