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Intravitreal bevacizumab for neovascular glaucoma
Deepta Vasudev1, Michael P Blair, John Galasso
1Eye and Ear Infirmary, University of Illinois, Chicago, Illinois 60612, USA.
Summary
Intravitreal bevacizumab combined with panretinal laser photocoagulation (PRP) improved long-term angle anatomy and intraocular pressure (IOP) control in neovascular glaucoma (NVG) patients compared to PRP alone. However, visual acuity outcomes remained poor.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
- Glaucoma Management
Background:
- Neovascular glaucoma (NVG) is a severe condition characterized by abnormal blood vessel growth in the iris and anterior chamber, leading to elevated intraocular pressure (IOP).
- Current treatments often involve panretinal laser photocoagulation (PRP), but outcomes can be variable.
Purpose of the Study:
- To compare the 6-month and 1-year outcomes of neovascular glaucoma (NVG) treated with intravitreal bevacizumab injection plus panretinal laser (PRP) versus PRP alone.
- To evaluate the efficacy of bevacizumab in conjunction with PRP for managing NVG, focusing on angle anatomy and IOP control.
Main Methods:
- A retrospective, consecutive case series design was employed.
- Patient charts with NVG and at least 6 months of follow-up were reviewed.
- Treatment groups included intravitreal bevacizumab (1.25 mg) followed by PRP, or PRP alone. Primary outcome was long-term angle anatomy; secondary outcomes included IOP, visual acuity, and disease control.
Main Results:
- Eyes treated with bevacizumab and PRP showed significantly improved mean sectors of open angle at 6 months (2.14 vs. 1.18, P < 0.05) and 1 year (2.27 vs. 1.18, P < 0.05) compared to PRP alone.
- Mean intraocular pressure (IOP) was significantly lower in the bevacizumab group at 6 months (18.28 mmHg vs. 23.33 mmHg, P = 0.05).
- Patient compliance and control of systemic diseases like diabetes and hypertension were noted as potential confounding factors.
Conclusions:
- Intravitreal bevacizumab combined with PRP demonstrates superior long-term preservation of open angle and better IOP control in NVG patients compared to PRP monotherapy.
- Despite improved anatomical and pressure outcomes, neovascular glaucoma remains associated with poor visual acuity outcomes.
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