title: Panretinal photocoagulation with simultaneous cryoretinopexy or intravitreal bevacizumab for neovascular glaucoma.
abstract: BACKGROUND
  To compare the therapeutic effects of panretinal photocoagulation (PRP) combined with intravitreal bevacizumab (IVB) and cryoretinopexy (CR-IVB) to that of PRP combined with IVB alone in eyes with neovascular glaucoma (NVG).
  
  
  METHODS
  Retrospective, consecutive, case-control study.
  
  
  METHODS
  The medical records of 102 eyes of 96 patients with NVG due to proliferative diabetic retinopathy, central retinal vein occlusion, and ocular ischemic syndrome were reviewed. The mean age of the patients was 59.6 ± 11.5 years, with a range of 34 to 84 years. Patients received either 1.25 mg/0.05 ml of IVB combined with 360° of cryotherapy of the peripheral retina (CR-IVB subgroup) or IVB alone (IVB alone subgroup) as adjunctive treatments to PRP. The patients were followed for at least 12 months. Fifty-four eyes of 49 patients had open-angle NVG; 30 of these eyes were treated by CR-IVB, and 24 eyes by IVB alone. Forty-eight eyes of 48 patients had angle-closure NVG; 22 of these eyes were treated by CR-IVB, and 26 eyes were by IVB alone. Failure was defined as a postoperative intraocular pressure (IOP) >21 mmHg for two consecutive follow-up visits, or the need of additional surgery such as trabeculectomy or diode laser cycloablation. The differences in the success rates between the CR-IVB and IVB alone subgroups for the eyes with open-angle and closed-angle NVG were compared.
  
  
  RESULTS
  The success rate at 12 months in eyes with open-angle NVG was 80.0% in the CR-IVB subgroup and 41.7% in the IVB alone subgroup (P = 0.0096). In eyes with angle-closure NVG, the success rate at 12 months was 22.7% in the CR-IVB subgroup and 0% in the IVB-alone subgroup (P = 0.030).
  
  
  CONCLUSIONS
  The significantly better IOP control after PRP combined with cryotherapy and IVB than after PRP with IVB alone indicates that cryotherapy enhances the effectiveness of PRP for neovascular glaucoma for at least 1 year.
authors.affiliation: Department of Ophthalmology, Teikyo University Chiba Medical Center, 3426-3, Anesaki, Ichihara-City, Chiba, 299-0111, Japan. newyear98mt@yahoo.co.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Juntaro
authors.initials: J
authors.lastname: Uehara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugawara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Baba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Inoue
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hata
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mitamura
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D003452:Cryosurgery; D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D015355:Glaucoma, Neovascular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D007511:Ischemia / Q000150:complications; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab