Abstract
ABSTRACTPurpose: To study the effect of injection bevacizumab on iris neovascularization (NVI) and angle neovascularization (NVA) and compare its efficacy in terms of visual outcome, NVI, NVA, and intraocular pressure (IOP) control between intracameral, intravitreal, and combined use.Materials and methods: This was a prospective study conducted at a tertiary center for patients of neovascular glaucoma (NVG), including 20 eyes of 20 patients. After thorough evaluation, patients were divided into three groups: Intracameral, intravitreal, or combined, according to the route of injection bevacizumab required.Results: About 30% of patients belonged to the age group 51 to 60 years of which 80% were female. In 50%, vein occlusion was the cause of NVG, and 50% needed intravitreal injection bevacizumab. After 4th week of injection 90% and after 12th week 60% were found to have absence of NVI. Patients who had IOP in the range of 11 to 20 mm Hg and 21 to 30 mm Hg showed lower IOP as compared to other groups. But no significant difference was noted in higher IOP groups. Only two patients required antiglaucoma surgery.There was no statistically significant difference in visual outcomes in any groups. In all routes, there were statistically significant changes in NVI and NVG in the 1st and 4th weeks.Conclusion: The effect of injection in all routes deteriorates after 8 weeks. Intracameral route of injection is found to be most effective in terms of control of IOP. There was no statistically significant difference in terms of improvement in best corrected visual acuity (BCVA) in any route. Injection bevacizumab is effective and statistically significant in reducing the need of antiglaucoma surgery for NVG patients.How to cite this article: Bhagat PR, Agrawal KU, Tandel D. Study of the Effect of Injection Bevacizumab through Various Routes in Neovascular Glaucoma. J Curr Glaucoma Pract 2016;10(2):39-48.
Highlights
In 50%, vein occlusion was the cause of Neovascular glaucoma (NVG), and 50% needed intravitreal injection bevacizumab
No significant difference was noted in higher intraocular pressure (IOP) groups
Intracameral route of injection is found to be most effective in terms of control of IOP
Summary
Glaucoma is a group of diseases characterized by cupping and atrophy of optic nerve head and has attendant visual field loss related to increased or normal intraocular pressure (IOP). Neovascular glaucoma (NVG) falls in the category of secondary angle-closure glaucoma. It is a serious disorder, which occurs as a late complication of ischemic and inflammatory retinopathies, tumors, and other causes. First documented in 1871, historically it has been referred to as a hemorrhagic glaucoma, thrombotic glaucoma, congestive glaucoma, 100-day glaucoma, and diabetic hemorrhagic glaucoma.[2] Central retinal vein occlusion (CRVO), proliferative diabetic retinopathy, carotid artery occlusive disease (CAOD), central retinal artery occlusion, retinoblastoma, malignant melanoma, and post retinal detachment surgery are major associa ted pathologies
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