title: Angiographic changes in iris and iridocorneal angle neovascularization after intravitreal bevacizumab injection.
abstract: OBJECTIVE
  To evaluate the effects of the intravitreal (IV) injection of bevacizumab on anterior segment neovascularization using anterior segment angiography.
  
  
  METHODS
  We observed 1 eye with iris and iridocorneal angle neovascularization and 3 with neovascular glaucoma from 4 patients with diabetic retinopathy in 3 eyes and central retinal vein occlusion in 1 eye. Two healthy eyes from 2 other patients served as control eyes. Three eyes, including 1 normal eye, were examined by iris angiography; the other eyes underwent iridocorneal angle angiography with fluorescein (FA) and indocyanine green (IA) using a Heidelberg Retina Angiograph 2. After angiography, 4 eyes with neovascularization were treated with IV bevacizumab (1.25 mg per 0.05 mL) and underwent angiography once more 4 to 6 days after treatment.
  
  
  RESULTS
  Iris angiography with indocyanine green revealed many iris vessels, but not dye leaking, in both normal and glaucomatous eyes, and the angiography with fluorescein showed intensive vessel leakage in the iris as well as iridocorneal angle neovascularization, but not in normal eyes. Angle angiography revealed vessel structures with indocyanine green and intensive leakage with fluorescein in the iris and showed iridocorneal angle neovascularization and neovascular glaucoma, whereas no vessel structures appeared with IA or FA in the normal eye. After IV bevacizumab injection in eyes with neovascularization, the vascular structure did not change with IA, but dye leakage remarkably decreased with FA in the iris and angle. However, newly formed vessels in the iris and iridocorneal angle seemed to disappear on slitlamp examination.
  
  
  CONCLUSIONS
  Intravitreal injection of bevacizumab effectively reduces vascular permeability, whereas newly formed vessels are still present in the iris and iridocorneal angle.
authors.affiliation: Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu, Japan. ganka-gaku@mbox.med.uoeh-u.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Ishibashi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tawara
authors.forename: Rika
authors.initials: R
authors.lastname: Sohma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kubota
authors.forename: Norihiko
authors.initials: N
authors.lastname: Toh
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002199:Capillary Permeability / Q000187:drug effects; D002924:Ciliary Body / Q000098:blood supply*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D015355:Glaucoma, Neovascular / Q000175:diagnosis / Q000188:drug therapy*; D006068:Gonioscopy; D006801:Humans; D007208:Indocyanine Green; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D007498:Iris / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000209:etiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D007208:Indocyanine Green