Combined diode laser cyclophotocoagulation and intravitreal bevacizumab (Avastin) in neovascular glaucoma.
BACKGROUND
Intravitreal injection of bevacizumab (Avastin) in eyes with neovascular glaucoma (NVG) has recently been shown to induce rapid regression of anterior segment neovascularization and has promise as adjunct treatment to diode laser cyclophotocoagulation (CPC) to control intraocular pressure (IOP). This study presents the outcome of concomitant treatment with CPC and intravitreal bevacizumab in painful poor visual potential eyes in a case series of consecutively diagnosed NVG.


METHODS
Twelve patients (14 eyes) were treated with CPC and concurrent intravitreal bevacizumab 0.05 mL (1.25 mg) and study end-points were IOP lowering, regression of anterior segment neovascularization and resolution of pain.


RESULTS
The mean preoperative IOP was 42.1 11.4 and was lowered to 16.6 7.1 mmHg at 1-month postoperatively. Anterior segment neovascularization regressed dramatically within 1 week of intravitreal bevacizumab in 12 eyes. Thirteen eyes reported persistent relief of ocular pain at 6 months following treatment.


CONCLUSIONS
Combined intravitreal bevacizumab and CPC treatment for NVG provides rapid control of anterior segment neovascularization and may lead to improved symptomatic relief and IOP control.
Ghosh
Sudipta
S
Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, Melbourne, Victoria, Australia.
Singh
Dalveer
D
Ruddle
Jonathan B
JB
Shiu
Michael
M
Coote
Michael A
MA
Crowston
Jonathan G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000869:Anterior Eye Segment / Q000098:blood supply; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D056965:Injections, Intraocular; D007429:Intraocular Pressure; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology; D010146:Pain / Q000503:physiopathology; D012008:Recurrence; D012086:Reoperation; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab