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1 General aspects (0)   1.1 Epidemiology (20)   1.2 Population genetics (3)   1.3 Pathogenesis (0)   1.4 Quality of life (7)   1.5 Glaucomas as cause of blindness (8)   1.6 Prevention and screening (8) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (8)   2.2 Cornea (27)   2.3 Sclera (2)   2.4 Anterior chamber angle (2)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (8)     2.5.2 Schlemms canal (3)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (2)     2.6.2 Outflow (1)       2.6.2.1 Trabecular meshwork (5)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (8)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (4)   2.9 Ciliary body (1)   2.10 Lens (1)   2.11 Vitreous body (1)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (3)   2.13 Retina and retinal nerve fibre layer (22)   2.14 Optic disc (22)   2.15 Optic nerve (1)   2.16 Chiasma and retrochiasmal central nervous system (4)   2.17 Stem cells (2)   2.20 Other (0) 3 Laboratory methods (0)   3.1 Microscopy (2)   3.2 Electron microscopy (2)   3.3 Immunohistochemistry (5)   3.4 Molecular genetics (0)     3.4.1 Linkage studies (1)     3.4.2 Gene studies (36)   3.5 Molecular biology incl. 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surgery (0)     12.8.1 Without tube implant (20)     12.8.2 With tube implant or other drainage devices (26)     12.8.3 Non-perforating (10)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (26)     12.8.11 Complications, endophthalmitis (5)   12.9 Trabeculotomy, goniotomy (0)   12.10 Cyclodestruction (7)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (7)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (1)     12.14.3 Phacoemulsification (5)   12.15 Capsulotomy (0)   12.16 Vitrectomy (1)   12.17 Anesthesia (4)   12.20 Other (3) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (2)       13.2.2.2 Improvement (1)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (6) 15 Miscellaneous (25)

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Abstract #27816 Published in IGR 13-1

Intravitreal bevacizumab in refractory neovascular glaucoma: A prospective, observational case series

Kotecha A; Spratt A; Ogunbowale L; dell'Omo R; Kulkarni A; Bunce C; Franks WA
Archives of Ophthalmology 2011; 129: 145-150

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Objective: To examine the efficacy of intravitreal bevacizumab for pain relief in eyes with refractory neovascular glaucoma. Methods: In this prospective case series, 52 eyes with neovascular glaucoma were administered intravitreal bevacizumab, 1.25 mg, and monitored for 6 months. The primary outcome measure was change in subjective pain score. Intraocular pressure and iris neovascularization were evaluated at each visit. Surgical intervention for control of intraocular pressure was performed according to clinical need. Results: Forty-two patients (44 eyes) completed the 6-month follow-up. Subjective pain score was reduced significantly 1 week after intravitreal bevacizumab injection and lasted throughout the follow-up period (median [interquartile range]: baseline, 3 [0-6]; week 1, 1 [0-3]; month 1, 0 [0-1]; month 3, 0 [0-1]; and month 6, 0 [0-0]; Kruskal-Wallis (chi)(2) 31.03; P<.001). A rapid, yet relatively transient, reduction in iris neovascularization was also noted (iris neovascularization grade at baseline, 4.0 [3-4]; week 1, 2.5 [1-4]; month 1,2.0 [1-4]; month 3, 3.0 [2-4]; and month 6, 3.0 [2-4], (chi)(2) 23.33; P<.001). Four eyes (8%) required more than 1 injection to facilitate further intraocular surgery. Conclusions: Intravitreal bevacizumab is a useful adjunct in the management of refractory neovascular glaucoma, producing rapid relief of pain. However, we found no evidence to suggest that intravitreal bevacizumab lowers intraocular pressure in eyes with angle closure; conventional medical, laser, and surgical treatment are still needed in these eyes. (copyright)2011 American Medical Association. All rights reserved. EMTREE DRUG INDEX TERMS (MAJOR FOCUS) bevacizumab (adverse drug reaction, drug therapy, intracameral drug administration, intravitreal drug administration)

W. A. Franks. Glaucoma Research Unit, Moorfields Eye Hospital, 162 City Rd, London EC1V 2PD, United Kingdom. wendy.franks@moorfields.nhs.uk

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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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