advertisement
Abstract #25592 Published in IGR 12-1
Bevacizumab as adjuvant for neovascular glaucoma
Beutel J; Peters S; Luke M; Aisenbrey S; Szurman P; Spitzer M S; Yoeruek E; Grisanti SActa Ophthalmologica 2010; 88: 103-109
Purpose: We aimed to evaluate the longterm effects of intraocular bevacizumab (Avastin((registered trademark))) injections as adjuvant treatment in patients with neovascular glaucoma. Methods: Twenty eyes of 18 consecutive patients with secondary neovascular glaucoma caused by proliferative diabetic retinopathy (n = 7), ischaemic central retinal vein occlusion (n = 7), ischaemic ophthalmopathy (n = 2) and retinal ischaemia resulting from persistent detachment (n = 2) were treated with intraocular bevacizumab injections (1.25 mg/0.05 ml) in addition to other treatments. The main outcome measure was the change in degree of iris rubeosis. Secondary outcomes included intraocular pressure (IOP), best corrected visual acuity (BCVA) and numbers of additional interventions or antiglaucoma medications administered after injection. Results: Mean ((plus or minus) standard deviation) follow-up was 67.7 (plus or minus) 13.8 weeks (range 50-93 weeks). At the last follow-up, complete regression of rubeosis was detectable in five (20%) eyes, incomplete regression in seven (35%), stabilization in six (30%), and an increase in two (10%) eyes. Mean IOP was 26.0 (plus or minus) 8.9 mmHg at baseline and significantly decreased to 14.75 (plus or minus) 5.3 mmHg at the last follow-up visit (p = 0.000005). Mean baseline BCVA (logMAR [logarithm of the minimum angle of resolution] 1.43 (plus or minus) 0.89) was stabilized during the follow-up period (logMAR 1.5 (plus or minus) 0.98). Patients received an average of 2.75 injections. Additional treatments were laser photocoagulation in 13 (65%) eyes, cyclodestructive procedure in 14 (70%), cryopexy in six (30%), drainage procedures in two (10%), and vitrectomy in five (25%) eyes. Conclusions: Bevacizumab may be beneficial as adjuvant treatment in neovascular glaucoma because of its anti-angiogenic properties and its ability to prevent establishment or progression of angular obstruction. The causative disease inducing the angiogenic process requires treatment in all cases. Antiglaucoma treatment is needed in cases of persistent elevated IOP.
S. Grisanti. Department of Ophthalmology, University of Luebeck Ratzeburger, Allee 160, 23538 Lubeck, Germany. salvatore.grisanti@uk-sh.de
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)