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Intravitreal Bevacizumab (Avastin) Treatment of Neovascular Glaucoma in Ocular Ischemic Syndrome

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초록

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 ㎜Hg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 ㎎/0.05㎖ injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 ㎜Hg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.

Abstract

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 ㎜Hg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 ㎎/0.05㎖ injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 ㎜Hg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.

참고문헌 (6)

  1. Michels S, "Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration: twelve-week result of an uncontrolled open-label clinical study", Ophthalmology, 112, pp.1035~1047 (2005)
  2. Reichel E, "Intravitreal bevacizumab for choroidal neovascularization and cystoid macular edema: a cost-effective treatment", Ophthalmic Surg Laser Imaging, 36, pp.270~271 (2005)
  3. Ferrata N, "Vascular endothelial growth factor: basic science and clinical progress", Endocr Rev, 25, pp.581~611 (2004)
  4. Howitz H, "Bevacizumab plus irnotecan, fluorouracil, and leucovorin for metastatic colorectal cancer", N Engl J Med, 350, pp.2335~2342 (2004)
  5. Rosenfeld PJ, "Optical coherence tomography finding after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration", Ophthalmic Surg Laser Imaging, 36, pp.331~335 (2005)
  6. Kahook MY, "intravitreal bevacizumab in a patient with neovascular glaucoma", Ophthalmic Surg Laser Imaging, 37, pp.144~146 (2006)

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