Ghost cell glaucoma after intravitreal bevacizumab for postoperative vitreous hemorrhage following vitrectomy for proliferative diabetic retinopathy

Ophthalmic Surg Lasers Imaging. 2010 Jan-Feb;41(1):72-7. doi: 10.3928/15428877-20091230-13.

Abstract

Background and objective: To report the occurrence of ghost cell glaucoma after intravitreal injection of bevacizumab for the treatment of postoperative vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy (PDR).

Patients and methods: Retrospective chart review from August 2006 to December 2007. Patients who had postoperative vitreous hemorrhage after vitrectomy for PDR and received an intravitreal injection of bevacizumab were enrolled in the study.

Results: Eight eyes of 8 patients (mean age: 46 years) were included. After intravitreal injection of bevacizumab, 4 (50%) eyes had clearance of vitreous hemorrhage. Three eyes developed ghost cell glaucoma within 1 week after intravitreal injection of bevacizumab. Of these, intraocular pressure was controlled in 1 eye through the use of anti-glaucoma medication, whereas the other 2 eyes needed surgical intervention to lower intraocular pressure and subsequently clear the vitreous hemorrhage.

Conclusion: Intravitreal injection of bevacizumab may accelerate the clearance of postoperative vitreous hemorrhage in cases of PDR. However, a high incidence of ghost cell glaucoma was observed. Caution should be exercised when administering an intravitreal injection of bevacizumab for a postoperative vitreous hemorrhage after vitrectomy for PDR.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / adverse effects*
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / surgery*
  • Female
  • Follow-Up Studies
  • Glaucoma / chemically induced*
  • Glaucoma / diagnosis
  • Humans
  • Injections
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / drug therapy*
  • Postoperative Hemorrhage / etiology
  • Prognosis
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vitrectomy*
  • Vitreous Body
  • Vitreous Hemorrhage / diagnosis
  • Vitreous Hemorrhage / drug therapy*
  • Vitreous Hemorrhage / etiology

Substances

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