Intracameral Injection of Bevacizumab for the Treatment of Neovascular Glaucoma

Purpose: To assess the duration of the effect of intracameral
bevacizumab in patients presenting with rubeosis iridis and
neovascular glaucoma (NVG). Methods: Retrospective analysis of 24
consecutive eyes of 24 patients with decompensated NVG (> 21 mm
Hg) treated with a single intracameral injection of bevacizumab
over a minimum follow-up of 6 months. The endpoint of the study was
the need for retreatment due to recurrence of raised intraocular
pressure (IOP). Secondary outcome was the course of visual acuity
(VA) and IOP over 6 months. Results: A Kaplan-Meier calculation
revealed a mean duration of the treatment effect of 23 +/- 4.4
days. Compared to mean IOP before treatment (26.3 mm Hg), decreases
to 17.5 mm Hg at 1 week after treatment (p < 0.002) and to 17.1
mm Hg (p < 0.005) at 6 months following a single injection were
seen. At 6 months, additional treatment was performed in 87.5% (n =
21) of eyes. VA remained stable or improved in 75% (n = 18) of all
cases. Conclusion: The IOP-lowering effect of intracameral
bevacizumab can be seen 1 week after the injection, but is limited
to a period of approximately 3 weeks. However, the fast and
effective response to intracameral bevacizumab injection opens a
time window for additional treatments, which are often necessary.
Copyright (C) 2011 S. Karger AG, Basel