Efficacy and Safety of Intracameral Bevacizumab for Treatment of Neovascular Glaucoma
3
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the long-term efficacy and safety of intracameral bevacizumab in patients with neovascularglaucoma. Methods: This retrospective study included 26 eyes of 26 neovascular glaucoma patients who received intracameralbevacizumab injection between January 2013 and May 2015, and were followed-up for at least1 year. All patients were treated with topical and/or systemic intraocular pressure (IOP)-lowering medications,intracameral bevacizumab, and panretinal photocoagulation (PRP). The main outcome measures werechanges in visual acuity, IOP, and neovascularization of the iris (NVI) and the anterior chamber angle (NVA). To assess the safety of intracameral bevacizumab, corneal endothelial changes were also determined usingspecular microscopy. Patients whose IOP was uncontrolled received IOP-lowering surgery. Clinical factorsassociated with IOP-lowering surgery were also investigated. Results: In all patients, intracameral bevacizumab resulted in a rapid and marked reduction of IOP, NVI, andNVA within 1 week. At 12 months after initial injection, 19 of 26 eyes (73%) underwent IOP-lowering surgery. The average interval between initial injection and surgical treatment was 33.6 ± 26.9 days. Baseline IOP(p = 0.018), NVA grade (p = 0.029), and incomplete PRP (p = 0.005) were identified as predictive factors forIOP-lowering surgery. During the follow-up period, there were no statistically significant corneal endothelialchanges after intracameral bevacizumab injection. Conclusions: During 1 year of follow-up after intracameral bevacizumab, the procedure was found to be safefor the corneal endothelium. However, the IOP-lowering effect was transient, and 73% of patients eventuallyrequired IOP-lowering surgery. Predictive factors for IOP-lowering surgery were high baseline IOP and NVAgrade, and incomplete PRP.
Abstract
Purpose: To evaluate the long-term efficacy and safety of intracameral bevacizumab in patients with neovascularglaucoma. Methods: This retrospective study included 26 eyes of 26 neovascular glaucoma patients who received intracameralbevacizumab injection between January 2013 and May 2015, and were followed-up for at least1 year. All patients were treated with topical and/or systemic intraocular pressure (IOP)-lowering medications,intracameral bevacizumab, and panretinal photocoagulation (PRP). The main outcome measures werechanges in visual acuity, IOP, and neovascularization of the iris (NVI) and the anterior chamber angle (NVA). To assess the safety of intracameral bevacizumab, corneal endothelial changes were also determined usingspecular microscopy. Patients whose IOP was uncontrolled received IOP-lowering surgery. Clinical factorsassociated with IOP-lowering surgery were also investigated. Results: In all patients, intracameral bevacizumab resulted in a rapid and marked reduction of IOP, NVI, andNVA within 1 week. At 12 months after initial injection, 19 of 26 eyes (73%) underwent IOP-lowering surgery. The average interval between initial injection and surgical treatment was 33.6 ± 26.9 days. Baseline IOP(p = 0.018), NVA grade (p = 0.029), and incomplete PRP (p = 0.005) were identified as predictive factors forIOP-lowering surgery. During the follow-up period, there were no statistically significant corneal endothelialchanges after intracameral bevacizumab injection. Conclusions: During 1 year of follow-up after intracameral bevacizumab, the procedure was found to be safefor the corneal endothelium. However, the IOP-lowering effect was transient, and 73% of patients eventuallyrequired IOP-lowering surgery. Predictive factors for IOP-lowering surgery were high baseline IOP and NVAgrade, and incomplete PRP.
참고문헌 (21)
- Shazly TA, "Neovascular glaucoma: etiology, diagnosis and prognosis", Semin Ophthalmol, 24, pp.113~121 (2009)
- Sivak-Callcott JA, "Evidencebased recommendations for the diagnosis and treatment of neovascular glaucoma", Ophthalmology, 108, pp.1767~1776 (2001)
- Doft BH, "Retinopathy risk factor regression after laser panretinal photocoagulation for proliferative diabetic retinopathy", Ophthalmology, 91, pp.1453~1457 (1984)
- Aiello LP, "Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders", N Engl J Med, 331, pp.331~1480 (1994)
- Tripathi RC, "Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma", Ophthalmology, 105, pp.232~237 (1998)
- Sasamoto Y, "Clinical outcomes and changes in aqueous vascular endothelial growth factor levels after intravitreal bevacizumab for iris neovascularization and neovascular glaucoma: a retrospective twodose comparative study", J Ocul Pharmacol Ther, 28, pp.41~48 (2012)
- Boyd SR, "Correlation of increased vascular endothelial growth factor with neovascularization and permeability in ischemic central vein occlusion", Arch Ophthalmol, 120, pp.1644~1650 (2002)
- Ehlers JP, "Combination intravitreal bevacizumab", panretinal photocoagulation versus panretinal photocoagulation alone in the treatment of neovascular glaucoma, 2008, pp.28, 696~702
- Wolf A, "Intracameral injection of bevacizumab for the treatment of neovascular glaucoma", Ophthalmologica, 226, pp.51~56 (2011)
- Krohne TU, "Intraocular pharmacokinetics of bevacizumab after a single intravitreal injection in humans", Am J Ophthalmol, 146, pp.508~512 (2008)
- Yazdani S, "Intravitreal bevacizumab for neovascular glaucoma: a randomized controlled trial", J Glaucoma, 18, pp.632~637 (2009)
- Wakabayashi T, "Intravitreal bevacizumab to treat iris neovascularization and neovascular glaucoma secondary to ischemic retinal diseases in 41consecutive cases", Ophthalmology, 115, pp.1571~1580 (2008)
- Weiss DI, "Neofibrovascularization of iris and anterior chamber angle: a clinical classification", Ann Ophthalmol, 10, pp.488~491 (1978)
- Fleiss JL, "Statistical methods for rates and proportions", pp.212~213 (1981), John Wiley and Sons
- Sugimoto Y, "Effect of intravitreal bevacizumab on iris vessels in neovascular glaucoma patients", Graefes Arch Clin Exp Ophthalmol, 248, pp.1601~1609 (2010)
- Bhagat PR, "Study of the effect of injection bevacizumab through various routes in neovascular glaucoma", J Curr Glaucoma Pract, 10, pp.39~48 (2016)
- Yazdani S, "Intravitreal bevacizumab (Avastin) injection for neovascular glaucoma", J Glaucoma, 16, pp.437~439 (2007)
- Kotecha A, "Intravitreal bevacizumab in refractory neovascular glaucoma: a prospective, observational case series", Arch Ophthalmol, 129, pp.145~150 (2011)
- Nakano S, "Prognostic factor analysis of intraocular pressure with neovascular glaucoma", J Ophthalmol, 2016, pp.1205895~ (2016)
- Hosny MH, "Effect of intracameral bevacizumab injection on corneal endothelial cells: an in vivo evaluation", J Ocul Pharmacol Ther, 25, pp.513~517 (2009)
- Park HY, "Effect of intracameral bevacizumab injection on corneal endothelium in rabbits", Cornea, 27, pp.1151~1155 (2008)