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Bevacizumab as adjuvant for neovascular glaucoma
Julia Beutel1, Swaantje Peters, Matthias Lüke
1Department of Ophthalmology, University of Lübeck, Lübeck, Germany.
Acta Ophthalmologica
|September 25, 2008
Summary
Intraocular bevacizumab injections effectively reduced intraocular pressure and iris rubeosis in neovascular glaucoma patients. Further treatment is often necessary for underlying causes and persistent high intraocular pressure.
Area of Science:
- Ophthalmology
- Vascular Biology
- Glaucoma Research
Background:
- Neovascular glaucoma is a severe condition characterized by abnormal blood vessel growth in the iris.
- This condition often leads to significant vision loss and elevated intraocular pressure.
- Adjuvant therapies are crucial for managing neovascular glaucoma effectively.
Purpose of the Study:
- To evaluate the long-term efficacy of intraocular bevacizumab (Avastin) injections as an adjuvant treatment for neovascular glaucoma.
- To assess the impact of bevacizumab on iris rubeosis, intraocular pressure (IOP), and visual acuity.
Main Methods:
- Twenty eyes of 18 patients with secondary neovascular glaucoma received intraocular bevacizumab injections (1.25 mg/0.05 ml) alongside other treatments.
- Primary outcome was the change in iris rubeosis; secondary outcomes included IOP, best corrected visual acuity (BCVA), and additional interventions.
- Follow-up averaged 67.7 weeks.
Main Results:
- Complete or incomplete regression of iris rubeosis was observed in 55% of eyes.
- Mean intraocular pressure significantly decreased from 26.0 mmHg to 14.75 mmHg (p = 0.000005).
- Best corrected visual acuity remained stable, and patients required an average of 2.75 injections, with many needing additional procedures like laser or surgery.
Conclusions:
- Intraocular bevacizumab demonstrates potential benefits in managing neovascular glaucoma due to its anti-angiogenic properties.
- Bevacizumab can help prevent the progression of angular obstruction in neovascular glaucoma.
- Comprehensive treatment addressing the underlying angiogenic cause and persistent elevated IOP remains essential.
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