April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Intravitreal bevicizumab anti-vascular endothelial growth factor therapy for radiation associated neovascular glaucoma
Author Affiliations & Notes
  • Ekaterina A Semenova
    Ocular Oncology, The New York Eye Cancer Center, New York, NY
  • Sonali Nagendran
    Ocular Oncology, The New York Eye Cancer Center, New York, NY
  • Paul T Finger
    Ocular Oncology, The New York Eye Cancer Center, New York, NY
  • Footnotes
    Commercial Relationships Ekaterina Semenova, None; Sonali Nagendran, None; Paul Finger, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5094. doi:
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      Ekaterina A Semenova, Sonali Nagendran, Paul T Finger; Intravitreal bevicizumab anti-vascular endothelial growth factor therapy for radiation associated neovascular glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5094.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To describe the effects of intravitreal bevicizumab anti-vascular endothelial growth factor therapy on radiation associated neovascular glaucoma.

Methods: This is a retrospective single centre interventional case series examining 12 eyes of 12 patients with ocular malignancies (10 uveal melanoma, 1 conjunctival melanoma, 1 ciliary body adenocarcinoma) who developed neovascular glaucoma after radiation therapy (11 plaque brachytherapy and 1 external beam teletherapy). All patients were treated with periodic 1.25 mg intravitreal bevicizumab injections. Outcome measures assessed included regression of iris neovascularization, change in intraocular pressure (IOP), visual acuity, pain control and enucleation.

Results: Regression of iris neovascularization occurred in 9/12 patients after the first injection. The intraocular pressure (IOP) decreased in 8/12 patients (67%) with a mean reduction of 9.25 mmHg across the study group. Visual acuity improved in 1/12 (8%), remained stable in 5/12 (42%) and deteriorated in 6/12 (50%). Patients were monitored for 24 months on average after the first injection. Six eyes subsequently underwent enucleation for pain control (4 patients, 66%), chronic uveitis (1 patient, 17%) and tumor recurrence (1 patient, 17%). The 6 patients that retained their eyes reported good pain control. Visual acuity ranged from 20/160 to no light perception. Intraocular pressures remained within the normal range in 4 patients, 3 of whom required continued periodic bevicizumab injections. Two patients had significantly raised but stable IOP and opted to stop treatment.

Conclusions: Intravitreal bevicizumab is a promising treatment for patients with radiation associated neovascular glaucoma who wish to avoid enucleation. Although visual acuities did not improve, there was clinical evidence of regression of iris neovascularization and treatment achieved pain control and acceptable IOP control in the majority of patients.

Keywords: 624 oncology • 609 neovascularization • 568 intraocular pressure  
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