Intravitreal bevacizumab (Avastin) treatment of neovascular glaucoma in ocular ischemic syndrome

Korean J Ophthalmol. 2009 Jun;23(2):132-4. doi: 10.3341/kjo.2009.23.2.132. Epub 2009 Jun 9.

Abstract

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 mmHg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 mg/0.05mL injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 mmHg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.

Keywords: Anti-VEGF; Bevacizumab; Ischemic ocular syndrome; Ischemic retinopathy; Neovascular glaucoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Carotid Stenosis / complications*
  • Carotid Stenosis / diagnosis
  • Diagnosis, Differential
  • Eye / blood supply*
  • Fluorescein Angiography
  • Fundus Oculi
  • Glaucoma, Neovascular / diagnosis
  • Glaucoma, Neovascular / drug therapy*
  • Glaucoma, Neovascular / etiology
  • Humans
  • Injections
  • Ischemia / complications*
  • Ischemia / diagnosis
  • Magnetic Resonance Angiography
  • Male
  • Vascular Endothelial Growth Factor A
  • Vitreous Body

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab