Intravitreal bevacizumab (Avastin) in the treatment of neovascular glaucoma.
OBJECTIVE
To describe a case series of neovascular glaucoma (NVG) caused by central retinal vein occlusion (CRVO) that was treated with intravitreal bevacizumab (IVB; Avastin).


METHODS
Retrospective interventional case series.


METHODS
Six consecutive patients with NVG and a refractory, symptomatic elevation of intraocular pressure (IOP) and pronounced anterior segment congestion received IVB (1.25 mg/0.05 ml). Diode laser cyclophotocoagulation was carried out only if pressure was controlled insufficiently by topical medication. Follow-up examinations occurred at four to 16 weeks.


RESULTS
IVB resulted in a marked regression of anterior segment neovascularization and relief of symptoms within 48 hours. IOP decreased substantially in three eyes; in the other three eyes, adjuvant cyclophotocoagulation was necessary. No side effects were observed. Panretinal photocoagulation (PRP) was performed as soon as feasible, five to 12 weeks after IVB treatment.


CONCLUSIONS
IVB leads to a rapid regression of iris and angle neovascularization and should be investigated more thoroughly as an adjunct in the management of NVG.
Iliev
Milko E
ME
Department of Ophthalmology, University of Bern, Inselspital, Bern, Switzerland. milko.lliev@insel.ch
Domig
Diego
D
Wolf-Schnurrbursch
Ute
U
Wolf
Sebastian
S
Sarra
Gian-Marco
GM
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D005260:Female; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D007498:Iris / Q000601:surgery; D017075:Laser Coagulation; D008297:Male; D012170:Retinal Vein Occlusion / Q000150:complications; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab