title: [Anti-VEGF therapy in the treatment of anterior segment neovascularization secondary to central retinal vein occlusion].
abstract: OBJECTIVE
  To evaluate the benefit of anti-VEGF in the treatment of anterior segment neovascularization (ASNV), a severe complication of ischemic central retinal vein occlusion (CRVO).
  
  
  METHODS
  This is a retrospective case series of consecutive patients with ASNV secondary to CRVO treated with anti-VEGF. Ophthalmic parameters were recorded for each visit: measurement of best visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography and optical coherence tomography. Minimum follow-up was 6 months.
  
  
  RESULTS
  Nineteen patients (19 eyes) received intravitreal injections of anti-VEGF in association with panretinal photocoagulation (PRP). In patients who had uncomplicated rubeosis iridis without elevated IOP (n=6), after a mean of 3 injections, VA was stable in 4 patients and improved by two lines in 2 patients. In patients with early neovascular glaucoma (NVG) (n=13), IOP reduction was observed in all eyes within 1 week after injection but increased secondarily after an average of 45 days, although the rubeosis had definitively disappeared, which suggested that the change in IOP was independent of ASNV. After a mean of 6 injections in combination with filtering or cyclodestructive surgery, IOP finally stabilized, but VA decreased in all patients. Three patients (50%) with stage III ASNV progressed to stage IV ASNV in spite of anti-VEGF treatment.
  
  
  CONCLUSIONS
  In all eyes, anti-VEGF treatment stopped neovascularization and helped to control IOP. However, vision was preserved only in the eyes with uncomplicated rubeosis at the time of diagnosis. Since only 32% of eyes were diagnosed at this stage, the authors suggest the prevention of ASNV by careful screening and follow-up of patients at risk, and the performance of PRP in CRVO with extensive retinal non-perfusion prior to the onset of rubeosis.
authors.affiliation: Centre hospitalier intercommunal de Créteil, hôpital Henri-Mondor, université Paris-Est-Créteil, 61, avenue du Général-de-Gaulle, 94010 Créteil, France; Clinique ophtalmologique de Bukavu, université de Bukavu, 231B, avenue P.E Lumumba, Bukavu, République démocratique du Congo. Electronic address: thkabesha@yahoo.com.
authors.forename: T B
authors.initials: TB
authors.lastname: Kabesha
authors.affiliation: Centre hospitalier intercommunal de Créteil, hôpital Henri-Mondor, université Paris-Est-Créteil, 61, avenue du Général-de-Gaulle, 94010 Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Glacet-Bernard
authors.affiliation: Centre hospitalier intercommunal de Créteil, hôpital Henri-Mondor, université Paris-Est-Créteil, 61, avenue du Général-de-Gaulle, 94010 Créteil, France.
authors.forename: O
authors.initials: O
authors.lastname: Rostaqui
authors.affiliation: Centre hospitalier intercommunal de Créteil, hôpital Henri-Mondor, université Paris-Est-Créteil, 61, avenue du Général-de-Gaulle, 94010 Créteil, France.
authors.forename: E H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D012170:Retinal Vein Occlusion / Q000150:complications*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D042461:Vascular Endothelial Growth Factor A
keywords: Anti-VEGF; Central retinal vein occlusion; Chirurgie filtrante; Filtering surgery; Glaucome néovasculaire; Injection intravitréenne; Intraocular pressure; Intravitreal injection; Ischémie rétinienne; Neovascular glaucoma; Néovascularisation irienne; Occlusion de la veine centrale de la rétine; Panretinal photocoagulation; Photocoagulation panrétinienne; Pression intraoculaire; Retinal ischemia; Rubeosis iridis