title: Intravitreal bevacizumab treatment for neovascular glaucoma: histopathological analysis of trabeculectomy specimens.
abstract: BACKGROUND
  Neovascular glaucoma (NVG) is a serious complication for patients with proliferative diabetic retinopathy (PDR). Bevacizumab is a full-length humanized monoclonal antibody that binds all isoforms of vascular endothelial growth factor (VEGF). Recently, encouraging results regarding the off-label use of intravitreal bevacizumab (IVB) for the treatment of NVG have been reported. We evaluated the histology of bevacizumab-treated trabeculectomy specimens to clarify IVB's biological effects on angle neovascularization.
  
  
  METHODS
  We retrospectively reviewed the charts of a consecutive series of 15 eyes of 13 patients who underwent trabeculectomy to treat NVG caused by PDR. In ten eyes of eight patients, 1.25 mg bevacizumab was injected intravitreally via the pars plana. Using light or electron microscopy, the surgically excised trabecular tissue was compared to that without IVB.
  
  
  RESULTS
  Light microscopy revealed decreased edema, fibrin deposition, inflammation and vascular congestion in the trabecular meshwork in specimens with IVB compared to those without IVB. Electron microscopy revealed endothelial cell degeneration in the bevacizumab-treated specimens.
  
  
  CONCLUSIONS
  The biological effects on angle neovascularization after IVB may involve reduced vascular permeability, decreased inflammatory reaction, loss of vascular function, and endothelial cell degeneration.
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoshida
authors.forename: Toshio
authors.initials: T
authors.lastname: Hisatomi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Ri-ichiro
authors.initials: R
authors.lastname: Kohno
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Murakami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Imaki
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ueno
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Fujisawa
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishibashi
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D015355:Glaucoma, Neovascular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014129:Trabecular Meshwork / Q000473:pathology* / Q000601:surgery; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab