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Response to ‘Comment on: ‘Neovascular glaucoma incidence and visual outcomes in treated proliferative diabetic retinopathy with anterior segment neovascularisation”

Eye (2026)Cite this article

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We thank Dr Zong for their thoughtful letter regarding our study on anterior segment neovascularisation (ASNV) [1]. As outlined in our paper, our aim was to provide prognostic insights based on anatomical stage, rather than to evaluate treatment timing or thresholds.

We agree with Dr Zong about the importance of activity status in ASNV. Distinguishing active from inactive disease is clinically valuable, but its primary utility lies in informing treatment decisions, for example, treat when active and observe when inactive, rather than serving as a prognostic indicator. Activity status does not reliably determine prognosis for two reasons. First, it is an unstable grouping that fluctuates over time, making it an unsuitable basis for assessing prognostic differences. For example, ASNV may be active at presentation, become inactive after anti-Vascular Endothelial Growth Factor (VEGF) therapy, reactivate as the anti-VEGF effect wanes, and later become inactive after adequate pan-retinal photocoagulation. By contrast, anatomical stage is a stable, reproducible classification that allows meaningful group comparisons in a retrospective cohort.

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Reference

  1. Fiddimore E, Al-Janabi A, Sulur Sundararajan R, Gallagher K. Neovascular glaucoma incidence and visual outcomes in treated proliferative diabetic retinopathy with anterior segment neovascularisation. Eye 2026;40:77–82.

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Authors and Affiliations

  1. Cwm Taf Morgannwg University Health Board, Royal Glamorgan Hospital, Llantrisant, UK

    Emma Fiddimore, Ahmed Al‑Janabi, Ramya Sulur Sundararajan & Kevin Gallagher

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  1. Emma Fiddimore
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  2. Ahmed Al‑Janabi
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  3. Ramya Sulur Sundararajan
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  4. Kevin Gallagher
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Contributions

EF and KG drafted the response. All authors contributed to revising the response and approved the final version.

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Correspondence to Kevin Gallagher.

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The authors declare no competing interests.

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Fiddimore, E., Al‑Janabi, A., Sulur Sundararajan, R. et al. Response to ‘Comment on: ‘Neovascular glaucoma incidence and visual outcomes in treated proliferative diabetic retinopathy with anterior segment neovascularisation”. Eye (2026). https://doi.org/10.1038/s41433-026-04351-1

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