Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma

Ciftci, Suleyman; Şakalar, Yıldırım Bayezit; Ünlü, Kaan; Keklíkçí, Uğur; Çaça, İhsan; Dogan, Eyup

doi:10.1177/112067210901900620

Cited by 21 publications

(16 citation statements)

References 16 publications

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“…Overall, the results are similar to those of other published series regarding immediate neovascular regression after intravitreal bevacizumab, with an initial increase and subsequent short-term reduction of intraocular pressure 3–8,10–14,16. However, only one paper reports acute angle closure glaucoma as a complication of intravitreal injection of bevacizumab 17.…”

Section: Discussionsupporting

confidence: 87%

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

Canut¹,

Alvarez²,

Nadal³

et al. 2011

OPTH

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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.

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Section: Discussionsupporting

confidence: 87%

“…The reduction observed at the end of follow-up can not only be related to treatment with intravitreal bevacizumab, but also to a combination of this treatment and the surgical procedures used 8,19–21. Intravitreal bevacizumab could improve visual outcomes and decrease the need for glaucoma surgery 22.…”

Section: Discussionmentioning

confidence: 99%

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

Canut¹,

Alvarez²,

Nadal³

et al. 2011

OPTH

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“…Secondarily, a filtering procedure associated with antimetabolites or an anterior chamber drainage implant may be used individually if necessary. Bevacizumab has been reported to lead to the regression of neovascularization in eyes with PDR and NVG [14,15]. …”

Section: Discussionmentioning

confidence: 99%

Pars Plana Ahmed Implantation Combined with 23-gauge Vitrectomy for Refractory Neovascular Glaucoma in Diabetic Retinopathy

Jeong

Nam

Paik

et al. 2012

Korean J Ophthalmol

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Purpose To evaluate the efficacy and safety of a pars plana Ahmed valve implantation combined with 23-gauge sutureless vitrectomy in the treatment of patients with medically uncontrolled neovascular glaucoma (NVG) in proliferative diabetic retinopathy (PDR). Methods The authors retrospectively reviewed the records of 11 consecutive patients with refractory NVG in PDR who underwent a 23-gauge sutureless vitrectomy combined with pars plana placement of an Ahmed valve implant. Control of intraocular pressure (IOP), pre- and postoperative best-corrected visual acuity and the development of intra- and postoperative complications were evaluated during the follow-up. Results The mean follow-up was 12.2 months (range, 8 to 25 months). Mean preoperative IOP was 35.9 ± 6.3 mmHg and mean postoperative IOP at the last visit was 13.3 ± 3.2 mmHg. Control of IOP (8 to 18 mmHg) was achieved in all patients, but 91% (10 of 11 patients) needed antiglaucoma medication (mean number of medications, 1.2 ± 0.6). Postoperative visual acuity improved in 11 eyes, and the logarithmically to the minimum angle of resolution mean visual acuity in these eyes improved from 1.67 ± 0.61 to 0.96 ± 0.67. The complications that occurred were transient hypotony in one case, transitory hypertension in two cases, and postoperative vitreous hemorrhage which spontaneously cleared in two cases. Conclusions We suggest the combination of 23-gauge pars plana vitrectomy and Ahmed valve implantation is safe and effective in PDR patients with refractory NVG.

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“…(21, 22) However, this is rarely occurs, as NVG patients often present late in the course of their disease, missing the narrow therapeutic window for prevention of angle closure and the need for glaucoma surgery. In patients with regressed NVA observed gonioscopically, angles may appear open, but transparent residual ghost vessel bodies may be present and form synechial membranes with closed angles that are recalcitrant to IOP treatment and require glaucoma surgery.…”

Section: Treatment Of Nvgmentioning

confidence: 99%

Medical and Surgical Treatment of Neovascular Glaucoma

Olmos

Lee

2011

International Ophthalmology Clinics

101

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Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma

Cited by 21 publications

References 16 publications

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

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

Pars Plana Ahmed Implantation Combined with 23-gauge Vitrectomy for Refractory Neovascular Glaucoma in Diabetic Retinopathy

Medical and Surgical Treatment of Neovascular Glaucoma

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