Sagong Min, Kim Jinseon, Chang Woohyok
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
Korean J Ophthalmol. 2009 Sep;23(3):215-8. doi: 10.3341/kjo.2009.23.3.215. Epub 2009 Sep 8.
We report three cases of neovascular glaucoma secondary to central retinal artery occlusion (CRAO) which were effectively managed with intravitreal bevacizumab (IVB) followed by panretinal photocoagulation (PRP). Neovascular glaucoma without peripheral anterior synechiae developed between one and five weeks following CRAO onset. All patients received 0.75 mg (0.03 ml) IVB. In all patients, complete regression of the iris and anterior chamber angle neovascularization was confirmed within one week. PRP was applied two weeks after the injection. The follow-up period was four to seven months (average, five months). Intraocular pressure was controlled in all patients using topical antiglaucoma medications alone. However, one patient experienced a recurrence of neovascularization three months after the initial combination treatment. This patient received another IVB injection and additional PRP, and the recurrent neovascularization resolved. There were no local or systemic adverse events in any patients. Therefore, intravitreal bevacizumab may be an effective adjunct in the treatment of neovascular glaucoma associated with CRAO.
我们报告了3例继发于视网膜中央动脉阻塞（CRAO）的新生血管性青光眼病例，这些病例通过玻璃体内注射贝伐单抗（IVB），随后进行全视网膜光凝（PRP）得到了有效治疗。在CRAO发作后的1至5周内，出现了无周边前粘连的新生血管性青光眼。所有患者均接受了0.75 mg（0.03 ml）的IVB注射。所有患者在1周内虹膜和前房角新生血管均完全消退。注射后2周进行PRP治疗。随访期为4至7个月（平均5个月）。所有患者仅使用局部抗青光眼药物即可控制眼压。然而，1例患者在初始联合治疗3个月后新生血管复发。该患者接受了另一次IVB注射和额外的PRP治疗，复发性新生血管消退。所有患者均未出现局部或全身不良事件。因此，玻璃体内注射贝伐单抗可能是治疗与CRAO相关的新生血管性青光眼的有效辅助手段。
