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1 General aspects (0)   1.1 Epidemiology (7)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (8)   1.5 Glaucomas as cause of blindness (5)   1.6 Prevention and screening (8) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (6)   2.2 Cornea (14)   2.3 Sclera (3)   2.4 Anterior chamber angle (3)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (6)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (4)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (3)   2.9 Ciliary body (6)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (0)   2.13 Retina and retinal nerve fibre layer (21)   2.14 Optic disc (17)   2.15 Optic nerve (5)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (1)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (1)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (3)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (16)   3.5 Molecular biology incl. 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Miscellaneous (31)

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Abstract #24991 Published in IGR 11-4

Intravitreal bevacizumab for treatment of neovascular glaucoma. Report of 20 cases

Douat J; Auriol S; Mahieu-Durringer L; Ancèle E; Pagot-Mathis V; Mathis A
Journal Français d'Ophtalmologie 2009; 32: 652-663

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INTRODUCTION: Bevacizumab is a recombinant humanised monoclonal antibody directed against the vascular endothelial growth factor (VEGF). We report the results of bevacizumab injections in the treatment of 20 cases of neovascular glaucoma. PATIENTS AND METHODS: Seven women and 13 men, of average age 73 years old, presented with neovascular glaucoma secondary to central retinal vein occlusion in 8 cases, proliferative diabetic retinopathy in 8 cases, central retinal artery occlusion in 2 cases, radiation retinopathy in 1 case and ocular ischemic syndrome in 1 case. Iris fluorescein angiography was performed before and two days after 2,5 mg intravitreal bevacizumab. Diode laser cyclophotocoagulation was realised in 12 cases of grade 4 neovascular glaucoma in the week following the injection. Panretinal photocoagulation was conducted in all cases. RESULTS: After a 4 months and a half follow up, iris angiography revealed dramatic regression of iris neovascularisation in a few days. In grade 2 and 3 neovascular glaucoma, the single injection is sufficient to control intraocular pressure. In grade 4 neovascular glaucoma, intraocular pressure was controlled in 87,5 % of cases with one injection and one or more diode laser cyclophotocoagulation. DISCUSSION: The antiangiogenic effect of bevacizumab leads to fast reduction of the iris neovascularization with control of intraocular pressure without any surgery in grade 2 or 3 neovascular glaucoma. Panretinal photocoagulation was facilitated by improvement of corneal swelling. Diode laser cyclophotocoagulation was necessary in grade 4. CONCLUSION: Intravitreal bevacizumab was effective in reversing iris neovascularization in association with panretinal photocoagulation and cyclophotocoagulation. LA: French

Service d'ophtalmologie, CHU Rangueil, Toulouse, France.

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Classification:

9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)

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