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G. D. Khare, S. Wilker, Q. D. Nguyen, L. Zhang, D. V. Do; Long-Term Follow-Up After Intravitreal Bevacizumab for Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4573.
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To assess long-term efficacy and safety of intravitreal bevacizumab for neovascular glaucoma (NVG).
All cases of NVG treated with intravitreal bevacizumab (IVB) from October 2005 to May 2007 at the Wilmer Eye Institute were identified through billing records and reviewed for clinical outcome.
A total of 23 eyes were treated with IVB for NVG and the mean duration of follow-up was 25 weeks (range 5 to 65 weeks). At the first follow-up visit (average 16.9 days), 13 (57%) eyes had a decrease in intraocular pressure (IOP) while the other 10 (43%) eyes had elevated IOP. A second IVB treatment was needed in 9 (39%) eyes after a mean of 92 days for recurrent NVG, and a third IVB treatment was required in 4 (17%) eyes. Despite IVB and maximal medical therapy, 5 (22%) eyes required tube shunt surgery after a mean of 8 days, 3 (13%) eyes required diode laser ciliary ablation after a mean of 18 days, and 1 (4%) eye required trabeculectomy after 42 days. No adverse ocular or systemic effects were noted.
To our knowledge, this study represents the longest duration of follow-up in eyes treated with IVB for NVG. Although IVB can rapidly lower IOP by causing regression of abnormal blood vessels present in NVG, this study demonstrates that a substantial number of patients still require either additional IVB treatment (39%) or glaucoma surgery (39%). Bevacizumab may serve as an adjunct therapy for NVG, but close follow-up of treated eyes is necessary because additional treatments of different modalities may be required to maintain a normal IOP.
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