Medical and Surgical Treatment of Neovascular Glaucoma

Olmos, Lisa C; Lee, Richard K.

doi:10.1097/iio.0b013e31821e5960

Cited by 90 publications

(115 citation statements)

References 20 publications

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“…These modalities have variable success rates depending on the intensity of IOP elevation, degree of ischemia-induced neovascularization, status of the angle and extent of glaucomatous damage incurred. 5 The role of antiangiogenic factors such as bevacizumab in the management of NVG is becoming increasingly popular and better established. We present here a case comparison study to examine the efficacy of intravitreal bevacizumab in eyes with NVG relative to eyes treated under similar circumstances but did not receive intravitreal bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

“…Based on our experience with managing these challenging cases, we have also proposed a treatment algorithm for NVG. 5 In summary, intravitreal bevacizumab is now a frequently used adjunct for the treatment of NVG. Bevacizumab is an important temporizing measure, used to bridge the patient to definitive treatment, including PRP and GDIs as needed.…”

Section: Discussionmentioning

confidence: 99%

“…5 If applied early, PRP can induce regression of both anterior and posterior segment neovascularization. 6 However, the response to adequate PRP is often incomplete, 7,8 and effective laser treatment may be hampered by the presence of cloudy media secondary to corneal edema, hyphema, cataract, and/or vitreous hemorrhage.…”

Section: Introductionmentioning

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%

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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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“…Many surgeons may opt for glaucoma drainage implant placement at the time of PPV and EL, after medical management with drugs and anti-VEGF agents, particularly if synechial angle closure is evident or suspected. 28 In the setting of trabeculectomy, bevacizumab has been used preoperatively, intraoperatively, postoperatively and for treatment of failing filtering blebs or during bleb revision. These studies have looked at intracameral, intravitreal, and subconjunctival administration.…”

Section: Trabeculectomymentioning

confidence: 99%