Clinical outcomes of patients with anterior segment neovascularization treated with or without intraocular bevacizumab

Abstract

The purpose of this study was to evaluate the clinical outcomes of patients with anterior segment neovascularization treated with or without intravitreal bevacizumab. This was a retrospective, comparative case series of 60 patients with anterior segment neovascularization: 30 consecutive patients treated with intravitreal bevacizumab and 30 age-, gender-, and race-matched controls treated without bevacizumab. The mean follow-up time was 9.1+/-6.3 months in the bevacizumab group and 8.6+/-6.2 months in the control group (P=0.769). At baseline, no significant difference was observed in initial visual acuity, intraocular pressure, gonioscopy, and iris or angle neovascularization (P=0.179, 0.432, 0.065, and 0.966, respectively). At the final examination, no significant difference was observed in mean intraocular pressure (P=0.464), mean number of glaucoma medications (P=1.00), or presence of anterior segment neovascularization (P=0.699). Final visual acuity better than 20/60 was achieved in six patients in the bevacizumab group and none in the control group (P=0.013). Comparison of linear regressions of baseline and final visual acuity (LogMAR) showed a significant difference between the two groups (P=0.040). In the bevacizumab group, 18 patients required glaucoma surgery, whereas 30 patients in the control group required surgery (P<0.001), usually with a glaucoma drainage implant. Both bevacizumab and control patients who presented with closed angles required glaucoma surgery (P=1.000). Treatment of anterior segment neovascularization with intravitreal bevacizumab significantly improves visual outcomes and significantly decreases the need for glaucoma surgery. In patients with closed anterior chamber angle, addition of bevacizumab treatment does not reduce the need for glaucoma surgery.