Al Sarireh Fawaz, Alrawashdeh Hamzeh Mohammad, Al Zubi Khalid, Al Salem Khalil
Department of Ophthalmology, College of Medicine, University of Mutah, Karak 61710, Jordan.
Department of Ophthalmology, Sharif Eye Centers, Irbid 410739, Jordan.
Int J Ophthalmol. 2021 Jun 18;14(6):855-859. doi: 10.18240/ijo.2021.06.10. eCollection 2021.
To assess the long-term effects of intraocular bevacizumab (Avastin) injections as an adjunctive drug to manage patients with neovascular glaucoma (NVG).
A retrospective study was conducted consisting of 34 eyes with secondary NVG caused by proliferative diabetic retinopathy (=25), ischemic central retinal vein occlusion (=8), and retinal ischemia resulting from persistent detachment (=1) were managed by intraocular injections of bevacizumab (1.25 mg/0.05 mL), in addition to other treatments. The main outcome measure was the change in the degree of iris neovascularization. Secondary outcomes included intraocular pressure and the number of additional interventions or antiglaucoma medications administered after injection.
All patients were followed-up for at least 12mo. At the last follow-up, complete regression of rubeosis irides was detectable in 13 (38.2%) eyes and incomplete regression in 21 eyes (61.8%). The mean intraocular pressure was 45.32±7.185 mm Hg at baseline and significantly decreased to 26.15±5.679 mm Hg at the last follow-up visit (=0.000005). Patients received an average of 4.97 injections. As additional treatments, 12 eyes (35%) received laser photocoagulation and 6 eyes (18%) underwent retinocryopexy. No further treatment was needed in 16 eyes (47.1%).
Intravitreal bevacizumab injection can have a favorable effect in controlling intraocular pressure and pain control in patients with NVG because it decreases the angiogenesis and helps to augment the results of conventional procedures. The primary cause of retinal ischemia should be always targeted.
评估玻璃体内注射贝伐单抗（阿瓦斯汀）作为辅助药物治疗新生血管性青光眼（NVG）患者的长期效果。
进行一项回顾性研究，纳入34只因增殖性糖尿病视网膜病变（=25）、缺血性中央视网膜静脉阻塞（=8）和持续性视网膜脱离导致的视网膜缺血（=1）引起的继发性NVG眼，除其他治疗外，通过玻璃体内注射贝伐单抗（1.25毫克/0.05毫升）进行治疗。主要观察指标是虹膜新生血管程度的变化。次要观察指标包括眼压以及注射后额外干预措施或抗青光眼药物的使用次数。
所有患者均随访至少12个月。在最后一次随访时，13只眼（38.2%）虹膜新生血管完全消退，21只眼（61.8%）不完全消退。基线时平均眼压为45.32±7.185毫米汞柱，在最后一次随访时显著降至26.15±5.679毫米汞柱（P=0.000005）。患者平均接受4.97次注射。作为额外治疗，12只眼（35%）接受了激光光凝，6只眼（18%）进行了视网膜冷冻治疗。16只眼（47.1%）无需进一步治疗。
玻璃体内注射贝伐单抗对控制NVG患者的眼压和疼痛有良好效果，因为它可减少血管生成并有助于增强传统治疗方法的效果。应始终针对视网膜缺血的主要原因进行治疗。
