Intravitreal bevacizumab as an adjunct treatment for neovascular glaucoma.
OBJECTIVE
To assess the effect of adjunctive intravitreal bevacizumab treatment on neovascular glaucoma (NVG).


METHODS
The medical records of all consecutive patients with NVG treated with intravitreal bevacizumab at our center from May 2006 to February 2008 were reviewed. The data collected included background features, findings on full ophthalmologic examination (including visual acuity, gonioscopy, and intraocular pressure), glaucoma medications prescribed, and additional procedures for glaucoma performed before and after bevacizumab injection.The interval between the diagnosis of NVG and intravitreal bevacizumab treatment was calculated.


RESULTS
Eighteen patients (6 male, 12 female; mean age 63-/+13.2 years) met the study criteria. Causes of NVG were proliferative diabetic retinopathy (n=14), central retinal vein occlusion (n=2), occlusive vasculitis (n=1), and panuveitis (n=1). The mean duration of followup was 52 (-/+12) weeks. Mean intraocular pressure decreased from 32.3 (-/+4.99) to 18 (-/+6.1) mmHg (p<0.0001) and mean number of glaucoma medications decreased from 3.16 (-/+1.2) to 2.55 (-/+1.46) (p=0.1938). An interval of less than 6 months between the start of bevacizumab treatment and diagnosis was associated with better final visual acuity than delayed treatment (0.82-/+0.4 logMAR vs 1.88-/+1.1 logMAR, p=0.002) and a better regression of iris neovascularization (22% vs 89%; p=0.015).


CONCLUSIONS
Intravitreal bevacizumab is beneficial for the treatment of anterior segment neovascularization and NVG when used as an adjunct, making the administration of additional treatment for the underlying cause possible. Bevacizumab should be instituted promptly after diagnosis, before irreversible anatomic and functional damage occurs.
Hasanreisoglu
Murat
M
Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva - Israel. rmurat95@yahoo.com
Weinberger
Dov
D
Mimouni
Karin
K
Luski
Moshe
M
Bourla
Dan
D
Kramer
Michal
M
Robinson
Anat
A
Axer-Siegel
Ruth
R
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000869:Anterior Eye Segment / Q000098:blood supply; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000068258:Bevacizumab; D005260:Female; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000209:etiology; D006068:Gonioscopy; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000959:Antihypertensive Agents; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab