Ryoo Na Kyung, Lee Eun Ji, Kim Tae-Woo
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Korean J Ophthalmol. 2013 Aug;27(4):299-303. doi: 10.3341/kjo.2013.27.4.299. Epub 2013 Jul 18.
To describe three cases of neovascular glaucoma (NVG) where iris or angle neovascularization regressed remarkably after subconjunctival bevacizumab injections used as the initial treatment before pan retinal photocoagulation (PRP) and/or filtering surgery. Three consecutive NVG patients whose intraocular pressure (IOP) was not controlled with maximal medication were offered an off-label subconjunctival injection of bevacizumab (2.5-3.75 mg/0.1-0.15 mL, Avastin). Bevacizumab was injected into the subconjunctival space close to the corneal limbus in two or three quadrants using a 26-gauge needle. Serial anterior segment photographs were taken before and after the injection. Following subconjunctival injection of bevacizumab, iris or angle neovascularization regressed rapidly within several days. Such regression was accompanied by lowering of IOP in all three cases. The patients underwent subsequent PRP and/or filtering surgery, and the IOP was further stabilized. Our cases demonstrate that subconjunctival bevacizumab injection can be potentially useful as an initial treatment in NVG patients before laser or surgical treatment.
描述三例新生血管性青光眼（NVG）病例，在进行全视网膜光凝（PRP）和/或滤过手术之前，结膜下注射贝伐单抗作为初始治疗后，虹膜或房角新生血管明显消退。连续三例使用最大剂量药物治疗仍无法控制眼压（IOP）的NVG患者接受了贝伐单抗（2.5 - 3.75 mg/0.1 - 0.15 mL，阿瓦斯汀）的结膜下非标签注射。使用26号针头在两个或三个象限靠近角膜缘的结膜下间隙注射贝伐单抗。在注射前后拍摄系列眼前节照片。结膜下注射贝伐单抗后，虹膜或房角新生血管在数天内迅速消退。在所有三例病例中，这种消退都伴随着眼压降低。患者随后接受了PRP和/或滤过手术，眼压进一步稳定。我们的病例表明，结膜下注射贝伐单抗作为NVG患者激光或手术治疗前的初始治疗可能是有用的。
