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S. Charles, P. Netland, A. P. C. Lupinacci, J. Calzada; Clinical Outcomes After Intraocular Bevacizumab (Avastin) in Patients With Anterior Segment Neovascularization: A Comparative Case Series. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4578. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the influence of intraocular bevacizumab on clinical outcomes in patients with elevated intraocular pressure and neovascularization of the iris and anterior chamber angle.
Retrospective comparative case series: 30 consecutive patients with anterior segment neovascularization (ASN) treated with intravitreal bevacizumab (IVB) after August 2005 and 30 age-, gender- and race-matched patients with ASN treated without IVB, before August 2005. VA was stratified into three categories: (1) less than 20/200; (2) between 20/200 and 20/60 and (3) better than 20/60.
Mean age was 68±10 years on the bevacizumab group and 66±13 years on the non-bevacizumab group (p= 0.398). The mean follow-up time was 9.1±6.3 mo in the bevacizumab group and 8.6±6.2 mo in the non-bevacizumab group (p=0.796). The majority of patients were diagnosed with diabetic retinopathy (IVB n=19, control n=20) followed by CRVO (IVB n=8, control n=7), p=0.166. No significant difference was observed in initial VA, gonioscopy, angle neovascularization, and iris neovascularization (p= 0.179; 0.065; 0.373 and 0.981, respectively). No significant difference was observed in initial mean IOP (IVB 40±14 mmHg, control 43±13 mmHg, p= 0.432) and mean number of glaucoma medications (IVB 3±2 medications, control 3±1 medications, p= 0.307). At final examination, no significant difference was observed in mean IOP (IVB 17±10 mmHg, control 15±11 mmHg, p= 0.628), mean glaucoma medications (IVB 1±1 medications, control 1±1 medications, p= 0.44) and presence of ASN (p=0.699). Final VA better than 20/60 was achieved in 6 patients in the bevacizumab group and none in the non-bevacizumab group (p=0.013). In the bevacizumab group 18 patients required glaucoma surgery, whereas 30 patients in the non-bevacizumab group required glaucoma surgery(p<0.001), usually with glaucoma drainage implant.
Intravitreal bevacizumab for anterior segment neovascularization significantly improves visual outcomes and significantly decreases need for glaucoma surgery.
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