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B. Iaccheri, T. Fiore, C. Cagini, L. Biondi, F. Pietrolucci, F. Florio, F. Giansanti, C. Fiore; Intravitreal Bevacizumab in Unusual Cases of Iris Neovascularization and Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3382.
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To assess the safety and efficacy of intravitreal injection of bevacizumab in patients with iris neovascularization (INV) and with neovascular glaucoma (NVG).
Noncomparative, interventional case series. Intravitreal bevacizumab (1 mg in 0.04 mL) was injected in 5 eyes of 4 patients. Two eyes presented INV due to rhegmatogenous retinal detachment (RD), while 3 eyes presented long lasting NVG (more than 1 year) due to proliferative diabetic retinopathy (PDR) (n =2), and central retinal artery occlusion (CRAO) (n= 1). Eyes with NVG had previously received cryotherapy and panretinal photocoagulation that failed to control intraocular pressure (IOP). The main outcome measurements were IOP, and regression of INV documented by color photographs of the anterior segment.
Complete clinically apparent regression of INV was observed in the 2 eyes with RD, while incomplete regression of INV was observed in the 3 eyes with long lasting NVG. IOP remained within normal limits in the 2 eyes with INV, while among the 3 eyes with NVG, IOP decreased from 50 mmHg to 35 mmHg in the eye with CRAO, remained unchanged (21 mmHg) in one eye with PDR and increased from 22 mmHg to 40 mmHg in one eye with PDR. No inflammation was observed.
Intravitreal injection of bevacizumab may be an effective and safe additional strategy to induce the regression of INV. In eyes with long-lasting NVG bevacizumab seems less effective in inducing INV regression and in restoring normal IOP. In eyes with long lasting NVG bevacizmab might also cause a contraction of the fibrovascular membrane covering the anterior chamber angle thus inducing an further damage or closure of trabecular meshwork with a following IOP increase.
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