Intraocular Bevacizumab (Avastin): for Rubeosis Iridis

Abstract

Purpose: : To determine whether intraocular bevacizumab decreases vascular leakage and rubeosis iridis in patients with neovascular glaucoma.

Methods: : The study included 18 eyes of 15 patients with secondary neovascular glaucoma due to proliferative diabetic retinopathy (n=9) or ischemic vessel occlusion (n=8). All patients received an intraocular injection of 1.0 mg of bevacizumab. Intraocular injection was performed in topical anaesthesia either in the anterior chamber (n=11) or via pars plana intravitreally (n=7). Rubeosis iridis and vascular leakage was investigated prospectively by iris fluorescein angiography.

Results: : Degree of rubeosis iridis decreased significantly (p<0.01) within 1 week after application. The improvement was maintained for at least 4 weeks. An inflammatory response with fibrinous reaction and pseudohypopyon was observed in one case one day after surgery. The reaction persisted only 1 day. An updated follow–up will be presented at the meeting

Conclusions: : Intraocular injection of bevacizumab may provide an additional strategy to the treatment of rubeosis iridis. Its long term effect and impact on neovascular glaucoma has to be determined.

Keywords: diabetic retinopathy • vascular occlusion/vascular occlusive disease • growth factors/growth factor receptors