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E. Eng, R. Leonard, S. Sarkisian, A. Reynolds, G. Skuta; Adjunctive Use of Bevacizumab in the Treatment of Neovaascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3395. doi: https://doi.org/.
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To evaluate the effect of bevacizumab as an adjunct to traditional treatments for neovascular glaucoma (NVG). Comparison of visual acuity, intraocular pressure, degree of neovascularization and treatment outcome to standard care was assessed.
The data consists of a retrospective review of a nonrandomized, interventional case series of patients undergoing treatment for neovascular glaucoma at the Dean A. McGee Eye Institute. All patients in the study were diagnosed with neovascular glaucoma (NVG) due to vein occlusion, ocular ischemic syndrome or diabetes. Patients diagnosed with NVG were offered bevacizumab after it was commercially available. Initial visual acuity, intraocular pressure, and clinical examination were compared to post-treatment results.
Eighteen patients (9 male and 9 female) were diagnosed with NVG over an 18 month span. The bevacizumab treated group was well matched in terms of initial IOP, VA, and degree of NVI/NVA compared to the traditional treatment group. Average follow-up was 3.5 months, with a range of 1 month to 9 months. The group utilizing bevacizumab as an adjunct (eight patients) experienced a near statistically significant reduction in IOP (p value 0.109) compared to the traditional treatment group. Three of these patients improved their VA, three patients maintained VA, and two patients lost vision. Clinical resolution of anterior segment neovascularization was seen in all but one patient (87.5%). In addition, adjunctive treatment with bevacizumab spared patients from requiring cyclodestructive procedures. There were no systemic or ocular complications related to the intravitreal injection of bevacizumab.
We demonstrated that bevacizumab as an adjunct in the treatment of NVG reverses NVI/NVA and is effective in lowering IOP. Further, long term study of bevacizumab for NVG is warranted.
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