Photodynamic therapy with verteporfin for anterior segment neovascularizations in neovascular glaucoma

Abstract

Purpose To evaluate photodynamic therapy (PDT) with verteporfin for iris and angle neovascularization in eyes with neovascular glaucoma. Design Interventional case series. Methods A prospective, noncomparative case series included four patients (four eyes) with neovascular glaucoma. PDT was performed following the parameters of treatment of age-related macular degeneration with photodynamic therapy Study Group (TAP). The laser was directed at the anterior chamber angle and iris surface using a Goldmann three-mirror contact lens. Iris and angle neovascularization were quantified using the number of clock hours involved. Outcome measures were obliteration of neovascularization and decrease of intraocular pressure (IOP). Results One week after PDT, we registered complete obliteration of angle neovascularization and partial occlusion of iris neovascularization. Subsequent reopening of angle neovascularization was detectable at 1 month. Intraocular pressure diminished considerably after 1 week, with a subsequent tendency toward stabilization. Conclusions Photodynamic therapy can be used safely and effectively in the early phases of neovascular glaucoma to achieve angle neovascularization obliteration and IOP reduction.