Efficacy of intravitreal bevacizumab with panretinal photocoagulation followed by Ahmed valve implantation in neovascular glaucoma.
OBJECTIVE
To establish the efficacy and safety of intravitreal bevacizumab (Avastin) with panretinal photocoagulation (PRP) followed by Ahmed valve implantation in the treatment of neovascular glaucoma (NVG).


METHODS
This prospective randomized study included 40 eyes of 40 patients with refractory NVG. Twenty eyes underwent Ahmed valve implantation with intravitreal bevacizumab (Avastin) (1.25 mg in 0.5 mL) and PRP and 20 eyes were managed by Ahmed valve and PRP (control group). The follow-up period was 18 months.


RESULTS
Complete success was defined as an intraocular pressure ≤ 21 mm Hg. Qualified success was considered when the above criteria were fulfilled but with additions of antiglaucoma topical medical treatment. The results revealed 95% total success (75% complete success and 20% qualified success) in the first group in which Avastin-augmented Ahmed valve was performed compared with 50% total success in the control group in which Ahmed valve implantation was performed alone (25% complete success and 25% qualified success).


CONCLUSIONS
Intravitreal bevacizumab (Avastin) with PRP followed by Ahmed valve implantation appears to be effective in the management of NVG.
Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Sharkeya, Egypt.
Reda A
RA
Mahdy
Waled M
WM
Nada
Khaled M
KM
Fawzy
Haitham Y
HY
Alnashar
Salah M
SM
Almosalamy
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D020327:Glaucoma Drainage Implants; D015355:Glaucoma, Neovascular / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019919:Prosthesis Implantation; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab