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D. V. Vasudev, M. P. Blair, J. Galasso, R. Kapur, T. Vajaranant; Intravitreal Bevacizumab for Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1375.
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© ARVO (1962-2015); The Authors (2016-present)
To report 6 month and 1 year outcomes of eyes treated for neovascular glaucoma (NVG) with intravitreal bevacizumab (BZB) injections and panretinal laser (PRP) compared to those receiving the PRP alone.
Charts of patients with NVG from retinal ischemia and at least 6 months of follow-up were retrospectively reviewed from the Retina and Glaucoma services at the IEEI from 01/2004 to 12/2007. Patients were treated with one injection of 1.25mg intravitreal BZB followed by PRP or with PRP alone. The primary outcome was the long term angle anatomy. Secondary outcomes included intraocular pressure, visual acuity, patient compliance, and control of systemic diseases. The angle was divided into 4 quadrants. Gonioscopic data was divided into three categories in each quadrant: open, neovascularization of the angle (NVA), or peripheral anterior synechiae (PAS). Visual Acuity was measured using the Snellen Visual Acuity chart. Statistical analysis was performed using Microsoft Excel and an online standard student-t test. Categorical values were compared using the Chi Square test.
14 eyes of 12 patients treated with BZB and PRP and 15 eyes of 11 patients treated with PRP alone were included in the study. Mean sectors of open angle at baseline was 1.31 in the BZB group and 1.47 in the retinal ablation group (p=0.73). Mean sectors of open angle was 2.14 and 1.18 in the BZB and retinal ablation groups respectively (p<0.05) at 6 month follow-up, and 2.27 and 1.18 respectively (p<0.05) at 1 year follow-up. Mean sectors of PAS at baseline was 1.43 and 1.53 in the BZB and retinal ablation groups (p=0.83). There was no difference in mean sectors of PAS between groups at any time point. Mean baseline IOP was 32.3 mmHg (+14.8) in the BZB group and 31.8 mmHg (+13) in the PRP group (p=0.75). At 6-month follow-up, the mean IOP was 18.28 mmHg (+10) in the BZB group and 23.33mmHg (+14.6) in the PRP group (p=0.05), and 19.12 mmHg (+6.8) and 26.2 mmHg (+18) (p=0.1) respectively at 1 year follow-up. Visual acuity at baseline was ≥20/200 in 3/15 eyes and 2/14 eyes in the retinal ablation and BZB groups respectively (p=0.68), which remained unchanged at later time points.
This study is one of the first to document better long term preservation of open angle in eyes receiving BZB along with PRP.
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