Bevacizumab Injected Into Silicone Oil in Eyes With Neovascular Glaucoma
Bevacizumab Injected Into Silicone Oil in Eyes With Neovascular Glaucoma
Purpose To evaluate the effect of intra-silicone injection of bevacizumab for the treatment of neovascular glaucoma (NVG) after vitrectomy for advanced proliferative diabetic retinopathy.
Methods Bevacizumab was injected into the silicone oil in five pseudophakic eyes of five patients with NVG. The iris neovascularization (INV) and NVG had developed 1.5–4 months after vitrectomy and silicone oil tamponade. The main outcome measures were regression of INV, intraocular pressure and visual acuity.
Results In all eyes, INV regressed and intraocular pressure was controlled within 7 days. Visual acuity improved in all eyes. In one patient, INV and NVG recurred 10 weeks after the injection and was successfully treated with a repeat intra-silicone bevacizumab injection.
Conclusion Intra-silicone injection of bevacizumab is effective in the treatment of patients with INV and NVG after vitrectomy for advanced proliferative diabetic retinopathy.
Vascular endothelial growth factor (VEGF) plays a central role in several ocular pathologies characterized by neovascularization and increased vascular permeability. Neovascular glaucoma (NVG) is a devastating complication associated with ischaemic retinopathies such as diabetic retinopathy. Standard treatment includes retinal photocoagulation and cyclodestructive or drainage procedures. Several studies have reported the value of intraocular anti-VEGF therapy with bevacizumab as a treatment for iris neovascularization (INV) associated with glaucoma.
Silicone oil is an important adjunct in the management of complex vitreoretinal surgical procedures. It has been extensively used as a tamponade in cases in which conventional vitreoretinal surgery is likely to result in a poor success rate. In the presence of silicone oil tamponade, the delivery and concentration of drugs injected into the posterior segment of the eye become unpredictable.
The aim of this pilot study was to investigate the value of intraocular anti-VEGF therapy with bevacizumab as a treatment for INV associated with glaucoma after vitrectomy and silicone oil tamponade for the treatment of advanced diabetic retinopathy.
Abstract and Introduction
Abstract
Purpose To evaluate the effect of intra-silicone injection of bevacizumab for the treatment of neovascular glaucoma (NVG) after vitrectomy for advanced proliferative diabetic retinopathy.
Methods Bevacizumab was injected into the silicone oil in five pseudophakic eyes of five patients with NVG. The iris neovascularization (INV) and NVG had developed 1.5–4 months after vitrectomy and silicone oil tamponade. The main outcome measures were regression of INV, intraocular pressure and visual acuity.
Results In all eyes, INV regressed and intraocular pressure was controlled within 7 days. Visual acuity improved in all eyes. In one patient, INV and NVG recurred 10 weeks after the injection and was successfully treated with a repeat intra-silicone bevacizumab injection.
Conclusion Intra-silicone injection of bevacizumab is effective in the treatment of patients with INV and NVG after vitrectomy for advanced proliferative diabetic retinopathy.
Introduction
Vascular endothelial growth factor (VEGF) plays a central role in several ocular pathologies characterized by neovascularization and increased vascular permeability. Neovascular glaucoma (NVG) is a devastating complication associated with ischaemic retinopathies such as diabetic retinopathy. Standard treatment includes retinal photocoagulation and cyclodestructive or drainage procedures. Several studies have reported the value of intraocular anti-VEGF therapy with bevacizumab as a treatment for iris neovascularization (INV) associated with glaucoma.
Silicone oil is an important adjunct in the management of complex vitreoretinal surgical procedures. It has been extensively used as a tamponade in cases in which conventional vitreoretinal surgery is likely to result in a poor success rate. In the presence of silicone oil tamponade, the delivery and concentration of drugs injected into the posterior segment of the eye become unpredictable.
The aim of this pilot study was to investigate the value of intraocular anti-VEGF therapy with bevacizumab as a treatment for INV associated with glaucoma after vitrectomy and silicone oil tamponade for the treatment of advanced diabetic retinopathy.