First Author: A.Rashed EGYPT
Co Author(s):
Purpose:
1.Asses the efficacy of intracameral bevacizumab to decrease the amount of anterior segment neovascularization evident on Iris Fluorescein Angiography(IFA). 2.Monitor the effect with IFA. 3.Evaluate the corneal endothelium by specular microscopy before and after injection.
Setting:
: Twenty five eyes of 25 consecutive patients with rubeosis iridis, referred to Ophthalmology Department in Kasr El Eini Hospitals, were recruited in this prospective study. All patients were seen in the period from July 2008 to July 2010.
Methods:
Preoperative evaluation: All cases were subjected to full slit lamp examination of the anterior segment, measurement of intraocular pressure (IOP), fundus examination, specular microscopy, and iris flourescein angiography. Inclusion criteria: Anterior segment neovascularization causing neovascular glaucoma. Exclusion Criteria: •Patients with decompensted corneal endothelium or low endothelial cell count. •Patients with congenital or acquired disturbed iris pattern, or with anterior chamber intraocular lenses. The protocol for intraocular injection in a surgical ward would be application of topical anaesthetic drops, disinfection, sterile draping and lid speculum, and injection of 1mg (0.04ml) of Bevazizumab(Avastin) into the anterior chamber, followed by prescription of oral acetazolamide 500mg tablets immediately after the procedure. Follow up: Early and late postoperative complications such as hyphema, intraocular pressure measurement, assesement of BCVA, endothelial integrity with specular microscopy, iris fluorescein angiography for a period of one week, one month, three months, and six months postoperatively.
Results:
The study showed marked regression of iris neovasculraization during the first week of follow up. Then the regression effect started to deteriorate over the next one month follow up and showed almost complete return of neovascularization in the last two follow up periods; 3 and 6 months. As to the endothelial cell count, it showed no marked drop in count during the whole follow up periods.
Conclusions:
Although bevacizumab is showing a promising strategy as adjunctive treatment of anterior segment neovascularization and neovascular glaucoma ,however; there is still a need for controlled prospective trials to establish long-term safety, efficacy, and dosing guidelines in retinal ischemia and neovascular glaucoma.
Financial Disclosure:
No
