First Author: S.Gamboa Saavedra SPAIN
Co Author(s): S. Bonafonte
Purpose:
Purpose: to report our results in 22 patients using intravitreal bevacizumab (IVB) for the treatment of neovascular glaucoma (NVG) in patients with diabetic retinopathy and our 2-5 years outcomes.
Setting:
Author: Gamboa Saavedra, S-Centro de Oftalmologķa Bonafonte-Barcelona-Spain
Methods:
Methods: we reviewed a serie of 22 eyes with NVG in patients with diabetic retinopathy. We
administered 1, 25 mg of IVB and then we perfomed PanPhotoCoagulation (PPC). We monitored this patients for 2-5 years.
Results:
Results: Pain was controlled in all eyes of our serie. We did not observe ophthalmic or systemic complications. We divided our serie in 3 groups:-16 eyes (73%) with open angle NVG and 6 eyes (27%) with closed angle NVG. From the first group: 6 eyes (27%) needed IVB + PRP, they had very good results, no pain, very good visual acuity and IOP controlled and 10 eyes (45%) needed multiple combinated therapies. In the other group:6 eyes with closed angle NVG needed additional surgery in all cases. Mean IOP was 34.4 mmHg +/- 13.6 at baseline, 22.32 mmHg +/- 8 at 2 years of follow up and 29.14 mmHg +/- 9.8 at 5 years of follow up.
Conclusions:
Conclusions: IVB can reduce iris and angle NV and inhibits further peripheral anterior synechia (PAS) formation temporarily. PPC inhibits NV constantly. Therefore, management of open angle NVG is more feasible with bevacizumab combinated with PPC.
IVB is usseful adjunct in the management of NVG either producing rapid relief of pain, reducing vascular permeability and decreasing inflammatory reaction. IVB can solve some cases where PRP or cyclophotocoagulation have failed. Preservation of open angle and IOP control are better with IVB + PRP. Bevacizumab in NVG causes short and long term regresson of retina and irirs new vessels. NVG is still associated with poor visual acuity outcomes. Clinical trials are needed to confirm these results. FINANCIAL DISCLOSURE?: No
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