Journal List > J Korean Ophthalmol Soc > v.49(4) > 1008252

Maeng, Kim, and Kee: Intraviteal Bevacizumab (Avastin®) Injection for the Treatment of Early-Stage Neovascular Glaucoma

Abstract

Purpose

This case is conducted to assess the short‐ term safety and efficacy of intravitreal bevacizumab injection in patient with early‐ stage of the neovascular glaucoma (NVG) without peripheral anterior synechiae.

Case summary

A 66‐ year‐ old patient with a history of proliferative diabetic retinopathy presented with neovascularization of the iris and the angle and high intraocular pressure of 30 mmHg. The patient received a single injection of bevacizumab (1.25 mg /0.05 mg) intravitreally. The visual acuity (VA), intraocular pressure (IOP), regression of the iris and the angle neovascularization were measured up to the twenty ninth week after injection. Regression of the iris and angle neovascularization were confirmed from the second week after injection. The visual acuity had continued stable and the IOP had been controlled from 30 mmHg to 20 mmHg from fifth week without the need for topical antiglaucoma medications until the twenty ninth week.

Conclusions

Bevacizumab may be an effective medication for the treatment of neovascular glaucoma. Bevacizumab seems to be a useful adjunct or an advantageous treatment option to panretinal photocoagulation in the treatment of neovascular glaucoma.

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Figure 1.
Clinical appearance of the iris before and after intravitreal injection of the bevacizumab (A) Before treatment: Neovascularization of the iris at the pupillary margin (B) One week after treatment: The neovascularization completely resolved and remained absent during the next twenty nine weeks.
jkos-49-696f1.tif
Figure 2.
Gonioscopic examination before (A) and two weeks after (B) the intravitreal injection of the bevacizumab. Note the regression of the neovascularization in the angle.
jkos-49-696f2.tif
Table 1.
Changes in the intraocular pressure, visual acuity and neovascularization of the iris and the angle after the intravitreal injection of the bevacizumab
base 4 hr 1 d 1 w 2 w 3 w 4 w 5 w 6 w 7 w 9 w 13 w 17 w 21 w 25 w 29 w
IOP 30 30 30 26 24 28 23 20 20 18 17 18 18 18 20 20
VA 0.5 0.5 0.4 0.4 0.4 0.4 0.4 0.5 0.4 0.3 0.5 0.5 0.5 0.5 0.5 0.5
NVI ++ ++ +
NVA ++ ++ + +/-

IOP=intraocular pressure (mmHg); VA=visual acuity; NVI=neovascularization of the iris; NVA=neovascularization of the angle.

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