Table 4.

Practical approach to NVG management based on clinical presentation

Clinical scenario	Suggested approach
Stage 1) Prerubeosis (Pre-stage)	Early and complete PRP, aggressive control of systemic causes (DM, RVO, OIS).
Stage 2) Rubeosis Iridis (Early Stage): Clear media	PRP ± intravitreal or combined anti-VEGF
Stage 3) Open-Angle NVG: High IOP, active rubeosis ± pain	Combined anti-VEGF + medical therapy → PRP or glaucoma surgery
Stage 4) Angle-Closure NVG: High IOP, active rubeosis, pain, poor visual prognosis	Combined anti-VEGF + medical therapy → glaucoma surgery / cyclodestructive procedures

Anti-VEGF: Anti–vascular endothelial growth factor; DM: Diabetes mellitus; IOP: Intraocular pressure; NVG: Neovascular glaucoma; OIS: Ocular ischemic syndrome; PRP: Panretinal photocoagulation; RVO: Retinal vein occlusion