Intravitreal bevacizumab for the treatment of neovascular glaucoma associated with central retinal artery occlusion

Korean J Ophthalmol. 2009 Sep;23(3):215-8. doi: 10.3341/kjo.2009.23.3.215. Epub 2009 Sep 8.

Abstract

We report three cases of neovascular glaucoma secondary to central retinal artery occlusion (CRAO) which were effectively managed with intravitreal bevacizumab (IVB) followed by panretinal photocoagulation (PRP). Neovascular glaucoma without peripheral anterior synechiae developed between one and five weeks following CRAO onset. All patients received 0.75 mg (0.03 ml) IVB. In all patients, complete regression of the iris and anterior chamber angle neovascularization was confirmed within one week. PRP was applied two weeks after the injection. The follow-up period was four to seven months (average, five months). Intraocular pressure was controlled in all patients using topical antiglaucoma medications alone. However, one patient experienced a recurrence of neovascularization three months after the initial combination treatment. This patient received another IVB injection and additional PRP, and the recurrent neovascularization resolved. There were no local or systemic adverse events in any patients. Therefore, intravitreal bevacizumab may be an effective adjunct in the treatment of neovascular glaucoma associated with CRAO.

Keywords: Central retinal artery occlusion; Intravitreal bevacizumab; Neovascular glaucoma; Panretinal photocoagulation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Female
  • Glaucoma, Neovascular / drug therapy*
  • Glaucoma, Neovascular / etiology*
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Recurrence
  • Retinal Artery Occlusion / complications*
  • Retreatment
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vitreous Body

Substances

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