Anti-vascular endothelial growth factor for neovascular glaucoma

Simha, Arathi; Braganza, Andrew; Abraham, Lekha; Samuel, Prasanna; Lindsley, Kristina

doi:10.1002/14651858.cd007920.pub2

Cited by 53 publications

(56 citation statements)

References 53 publications

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“…24,28,30,33,36,[42][43][44][45] A systematic review of literature in 2013 concluded that no compelling evidence exists from which reliable conclusions could be drawn comparing the effects of anti-VEGF agents either alone or as an adjunctive modality to other forms of treatment but no anti-VEGF agents in NVG. 46 The review identified two RCTs evaluating intravitreal bevacizumab injection in NVG. 40,41 Wittström et al 40 randomized 19 eyes with NVG secondary to ischemic CRVO to either intravitreal bevacizumab and PRP (10 eyes) or PRP alone (9 eyes).…”

Section: Discussionmentioning

confidence: 99%

“…However, the heterogeneity and uncontrolled assignment of adjunctive treatment modalities, as well as the small number of participants were major drawbacks of these RCTs. 46 As we previously recommended, 22 the standard of care for NVG at BPEI includes (1) administering intravitreal bevacizumab at the time of NVG diagnosis or before glaucoma surgery; (2) administering PRP if an adequate view of the posterior pole exists, or applying endolaser during PPV (if indicated with or without glaucoma surgery); and (3) lowering IOP medically and via placement of a GDI as necessary, or, if the vision is not considered useful, cyclophotocoagulation. Based on our experience with managing these challenging cases, we have also proposed a treatment algorithm for NVG.…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Olmos

Sayed

Moraczewski

et al. 2015

Eye

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Aims To compare the outcomes of neovascular glaucoma (NVG) treated with and without intravitreal bevacizumab in a large case comparison study. Methods The study is a retrospective, comparative, case series of 163 eyes of 151 patients with NVG, including 99 treated without and 64 treated with intravitreal bevacizumab. Medical and surgical treatments for NVG were assessed. The main outcome measures were visual acuity (VA) and intraocular pressure (IOP).Results At the time of NVG diagnosis, the median VA was count fingers (CF) in the non-bevacizumab group and 2/300 in the bevacizumab group. IOP (mean ± SD) was 43.1 ± 13.0 mm Hg in the non-bevacizumab group and 40.8 ± 11.5 mm Hg in the bevacizumab group. IOP (mean ± SD) decreased to 18.3 ± 13.8 mm Hg in the nonbevacizumab group and 15.3 ± 8.0 mm Hg in the bevacizumab group, and the median VA was CF in both treatment groups at a mean follow-up of 12 months. Panretinal photocoagulation (PRP) substantially reduced the need for glaucoma surgery (Po0.001) in bevacizumab treated NVG eyes. Conclusions Although bevacizumab delayed the need for glaucoma surgery, PRP was the most important factor that reduced the need for surgery. Vision and IOP in eyes with NVG treated with bevacizumab showed no long-term differences when compared with eyes that were not treated with bevacizumab. Thus, intravitreal bevacizumab serves as an effective temporizing treatment, but is not a replacement for close monitoring and definitive treatment of NVG. PRP remains the treatment modality that affects the course of NVG in terms of decreasing the need for surgery to control IOP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Olmos

Sayed

Moraczewski

et al. 2015

Eye

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“…The advent of anti-vascular endothelial growth factor (anti-VEGF) drugs and their use as an adjuvant for glaucoma surgery in NVG has dramatically increased the success of trabeculectomy [34][35][36]. In a prospective interventional study, Liu et al randomized 37 eyes of 36 patients with NVG to AGV implantation (19 patients) or combined trabeculectomy with intravitreal ranibizumab injection (18 patients) [37].…”

Section: Ahmed Glaucoma Valve Versus Trabeculectomymentioning

confidence: 99%

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

et al. 2017

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The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

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“…The quantity of growth factors in the aqueous decrease after intraocular injection of anti-VEGFs, decreasing further progression of angular damage secondary to IOP increments. 3 Several studies propose the use of anti-VEGF agents with traditional treatments such as PRP, with or without additional surgery and vary in the timing, combination, and place of injection (intracameral or intravitreal, or both simultaneously). The most frequent recommendation by various authors for treatment is the adjunct combination of intravitreal bevacizumab/panretinal photocoagulation for the treatment of NVG instead of PRP alone or as alternative treatment when visibility of the posterior segment is difficult due to opacities of the media (e.g.…”

Section: How To Cite This Articlementioning

confidence: 99%

Visual Prognosis With the Various Modalities of Treatment Available for Neovascular Glaucoma at a Tertiary Level Hospital

A¹,

K²

2018

jebmh

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BACKGROUNDNeovascular glaucoma (NVG) is a refractory type of glaucoma. In neovascular glaucoma elevation of IOP is caused by synechial angle closure through contraction of fibrovascular tissue. The symptoms of NVG are distressing, the visual loss severe and glaucoma intractable. Timely treatment with photocoagulation and Modified trabeculectomy and Artificial filtering shunts offers the patient a symptom-free life if not better vision. Intravitreal anti-VEGF cause rapid regression of iris and angle neovascularisation helping in the therapy of NVG.

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Anti-vascular endothelial growth factor for neovascular glaucoma

Cited by 53 publications

References 53 publications

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations

Visual Prognosis With the Various Modalities of Treatment Available for Neovascular Glaucoma at a Tertiary Level Hospital

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