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Anterior segment changes following intravitreal bevacizumab injection for treatment of neovascular glaucoma.

Canut MI, Alvarez A, Nadal J, Abreu R, Abreu JA, Pulido JS - Clin Ophthalmol (2011)

Bottom Line: We observed a significant difference (P = 0.021) between initial and mean neovascularization at three months in all the quadrants.At three months, median intraocular pressure was 19 ± 5.38 (range 12-26) mmHg.One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.

View Article: PubMed Central - PubMed

Affiliation: Glaucoma Section, Institut Universitari Barraquer, Universidad Autonoma de Barcelona, Barcelona, Spain. mcanut@co-barraquer.es

ABSTRACT

Background: The purpose of this study was to describe anterior segment changes in a prospective, interventional, noncomparative case series of patients with neovascular glaucoma secondary to proliferative diabetic retinopathy treated with intravitreal bevacizumab.

Methods: Five consecutive patients with neovascular glaucoma and a refractory, symptomatic elevation of intraocular pressure and pronounced anterior segment congestion received intravitreal bevacizumab 1.25 mg/0.05 mL. Follow-up examinations were performed at 4-16 weeks by the same specialists, with testing performed at hour 48, week 1, and months 1, 3, and 6 after intravitreal bevacizumab.

Results: We observed a significant difference (P = 0.021) between initial and mean neovascularization at three months in all the quadrants. At three months, median intraocular pressure was 19 ± 5.38 (range 12-26) mmHg. In three of the five cases, diode laser cyclophotocoagulation was required, and in one case a trabeculectomy was performed. One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.

Conclusion: Intravitreal bevacizumab achieves complete regression of neovascularization in neovascular glaucoma secondary to proliferative diabetic retinopathy, and this regression is stable when associated with treatment of the underlying disease and should be investigated more thoroughly as an adjunct in the management of neovascular glaucoma.

No MeSH data available.


Related in: MedlinePlus

Case 5. Anterior chamber image obtained by anterior segment optical coherence tomography prior to treatment. Notice the narrow but open angle.
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f1-opth-5-715: Case 5. Anterior chamber image obtained by anterior segment optical coherence tomography prior to treatment. Notice the narrow but open angle.

Mentions: Patient 5 was a 61-year-old man with a 20-year history of poorly controlled diabetes mellitus presented with proliferative diabetic retinopathy previously treated with partial peripheral panretinal photocoagulation and cryocoagulation. He had neovascular glaucoma with rubeosis in the entire iris and angle, with an intraocular pressure of 23 mmHg on maximum topical and systemic therapy. At 48 hours after intravitreal bevacizumab, we observed a decrease in anterior chamber amplitude as well as complete synechial angle closure (see Figures 1 and 2), and his intraocular pressure had increased to 50 mmHg. Diode laser cycloablation of the ciliary body was performed.


Anterior segment changes following intravitreal bevacizumab injection for treatment of neovascular glaucoma.

Canut MI, Alvarez A, Nadal J, Abreu R, Abreu JA, Pulido JS - Clin Ophthalmol (2011)

Case 5. Anterior chamber image obtained by anterior segment optical coherence tomography prior to treatment. Notice the narrow but open angle.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104802&req=5

f1-opth-5-715: Case 5. Anterior chamber image obtained by anterior segment optical coherence tomography prior to treatment. Notice the narrow but open angle.
Mentions: Patient 5 was a 61-year-old man with a 20-year history of poorly controlled diabetes mellitus presented with proliferative diabetic retinopathy previously treated with partial peripheral panretinal photocoagulation and cryocoagulation. He had neovascular glaucoma with rubeosis in the entire iris and angle, with an intraocular pressure of 23 mmHg on maximum topical and systemic therapy. At 48 hours after intravitreal bevacizumab, we observed a decrease in anterior chamber amplitude as well as complete synechial angle closure (see Figures 1 and 2), and his intraocular pressure had increased to 50 mmHg. Diode laser cycloablation of the ciliary body was performed.

Bottom Line: We observed a significant difference (P = 0.021) between initial and mean neovascularization at three months in all the quadrants.At three months, median intraocular pressure was 19 ± 5.38 (range 12-26) mmHg.One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.

View Article: PubMed Central - PubMed

Affiliation: Glaucoma Section, Institut Universitari Barraquer, Universidad Autonoma de Barcelona, Barcelona, Spain. mcanut@co-barraquer.es

ABSTRACT

Background: The purpose of this study was to describe anterior segment changes in a prospective, interventional, noncomparative case series of patients with neovascular glaucoma secondary to proliferative diabetic retinopathy treated with intravitreal bevacizumab.

Methods: Five consecutive patients with neovascular glaucoma and a refractory, symptomatic elevation of intraocular pressure and pronounced anterior segment congestion received intravitreal bevacizumab 1.25 mg/0.05 mL. Follow-up examinations were performed at 4-16 weeks by the same specialists, with testing performed at hour 48, week 1, and months 1, 3, and 6 after intravitreal bevacizumab.

Results: We observed a significant difference (P = 0.021) between initial and mean neovascularization at three months in all the quadrants. At three months, median intraocular pressure was 19 ± 5.38 (range 12-26) mmHg. In three of the five cases, diode laser cyclophotocoagulation was required, and in one case a trabeculectomy was performed. One patient showed complete synechial angle closure 48 hours after treatment which required cyclodestructive procedures to normalize intraocular pressure.

Conclusion: Intravitreal bevacizumab achieves complete regression of neovascularization in neovascular glaucoma secondary to proliferative diabetic retinopathy, and this regression is stable when associated with treatment of the underlying disease and should be investigated more thoroughly as an adjunct in the management of neovascular glaucoma.

No MeSH data available.


Related in: MedlinePlus