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Abstract #6441 Published in IGR 3-2
Regression of neovascular iris vessels by intravitreal injection of crystalline cortisone
Jonas JB; Hayler JK; Söfker A; Panda-Jonas SJournal of Glaucoma 2001; 10: 284-287
PURPOSE: To report the clinical outcome of patients who received an intravitreal injection of crystalline triamcinolone acetonide as treatment for neovascular glaucoma. PATIENTS AND METHODS: The study included 14 eyes of 14 patients with secondary neovascular glaucoma attributable to proliferative diabetic retinopathy (n = 9) or ischemic central retinal vein occlusion (n = 5). All patients received an intravitreal injection of 20 mg of crystalline triamcinolone acetonide as the only procedure (n = 4) or in combination with additional procedures, such as goniosynechiolysis (n = 1), phacoemulsification and intraocular lens implantation (n = 2), or transscleral peripheral retinal cryocoagulation (n = 7). Mean follow-up time was 3.10 ± 2.40 months (median, 3.5 months; range, 0.50-5.7 months). Goniosynechiolysis was carried out in those patients in whom the anterior chamber was circumferentially closed. RESULTS: After surgery, including the first days after surgery, the patients were nearly pain-free. Intraocular pressure (IOP) was significantly (p < 0.01) reduced from 33.4 ± 14.5 mmHg before surgery to 20.7 ± 8.2 mmHg at the end of the follow-up period. Postoperative visual acuity (mean, 0.09 ± 0.07; median, 0.10; range, finger counting to 0.25) was slightly but not significantly (p = 0.31) better than the preoperative values. Degree of rubeosis iridis decreased significantly (p = 0.02) from 2.6 ± 1.3 to 1.3 ± 1.2 relative units. When only considering the four patients in whom the intraocular cortisone injection was the only procedure performed, mean IOP decreased from 26.5 ± 12.1 to 21.75 ± 11.3 mmHg. CONCLUSION: Intravitreal injection of crystalline cortisone with most of the vehicle removed may be a potentially useful additional tool in the treatment of neovascular glaucoma.
Dr J.B. Jonas, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 103, D-68167 Mannheim, Germany. Jost.Jonas@ma.augen.uniheidelberg.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)