Combined diode laser cyclophotocoagulation and intravitreal bevacizumab (Avastin) in neovascular glaucoma

Introduction: Transscleral diode laser cyclophotoco-agulation is new cyclodestructive procedure for the treatment of refractory, advanced glaucoma. Comparing to other cyclophotocoagulation it is more safe and selective. Aim of the study: To evaluate the efficacy and safety of transscleral diode laser cyclophotocoagulation in treatment of refractory glaucoma. Material: A retrospective cohort study included 35 patients (36 eyes) with refractory glaucoma treated in Centre for Sight "Oftalmika", form March 2008 to February 2012. All patients were treated by transscleral diode laser cyclophotocoagulation. The mean age was 68.8 ? 16.8 years. Most prevalent type was the neovascular glaucoma (23 ili 65.7%). The treatment consisted of 16-20 applications of 1.5-2.0 W energy applied for 1.5-2.0 seconds. Results: The average IOP reduction was 33.4mmHg or 63,1%. The best treatment result was achieved in the neovascular glaucoma, where IOP reduction 6 months after the procedure was 71,2 %. The poorest results were obtained in congenital glaucoma (28,5%). Prior ciclodestructive procedures and/or filtration glaucoma procedures did not influence laser treatment results. In only 5,7% patients repeated procedures were indicated. Overall complication rates was 22,8%, and the most prevalent complications were hyphema and reversible keratopathy (8,6% eyes). Postoperative hypothonia had one patient. Number of antiglaucoma medications, 6 months after the treatment, was reduced by 1,1 (45,7%). Medication reduction was most prevalent in the case of seconday glaucoma 1,4 (52,6%), and the least prevalent in congenital glaucoma 0,5 (14,3%). Only one patient had occasional pain after the procedure. Conclusion: Transscleral diode laser cyclophotoco-agulation is safe and effective procedure in the treatment of refractory glaucoma. The best treatment result was achieved in the neovascular glaucoma, and the poorest in congenital glaucoma. Effect of the procedure on pain relif is unequivocal.

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Comparison of the efficacy of diode laser cyclophotocoagulation alone or in conjunction with Avastin in treatment of pseudovascular glaucoma

Oftalmologicheskii Zhurnal ◽

10.31288/oftalmolzh200932023 ◽

2009 ◽

Vol 19 (3) ◽

pp. 20-23

Author(s):

Ahmed M. Emarah ◽

Mostafa A El-Helw ◽

Mohammed A Hassaballa ◽

Heba A ElGuindy ◽

Mohammed A Fakery

Keyword(s):

Diode Laser ◽

Diode Laser Cyclophotocoagulation

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Rubeosis iridis and macular hemorrhages from multiple Corkscrew retinal vessels in a patient with NF1

European Journal of Ophthalmology ◽

10.1177/1120672121996636 ◽

2021 ◽

pp. 112067212199663

Author(s):

Marilyn A Márquez ◽

Claudio P Juárez ◽

Maria C Sánchez ◽

Jose D Luna

Keyword(s):

Intravitreal Bevacizumab ◽

Visual Outcome ◽

Neovascular Glaucoma ◽

Retinal Vessels ◽

Retinal Hemorrhages ◽

Fluorescein Angiogram ◽

Rubeosis Iridis ◽

Good Visual Outcome ◽

Av Malformation ◽

Sudden Decrease

Purpose: To report a case of a patient with NF1 presenting with ocular findings of AV malformation, multiple retinal hemorrhages, and neovascular glaucoma in the absence of retinal ischemia. Methods: Review of the medical record was conducted in accordance with the local IRBt. Results: A 60-year-old female patient with diagnosis of Neurofibromatosis type1 (NF1) and sudden decrease of vision in her left eye was found to have rubeosis iridis and high intraocular pressure (IOP). On fundus exam multiple corkscrew retinal vessels and retinal hemorrhages were present in her left eye. On Optical Coherence Tomography (OCT) the foveal hemorrhages appeared as outer layer hyperreflective retinal infiltrates whereas in the parafoveal area the hyperreflectivity was present between the RPE and neurosensory retina. Fluorescein Angiogram (FA) showed normal perfusion and no areas of leakage or ischemia. Treatment with anti-angiogenics in a timely manner correlated with a good visual outcome. Conclusions: We present a unique patient with NF1, rubeosis iridis, high IOP, and macular hemorrhages from multiple corkscrew retinal vessels in a well perfused retina, who underwent treatment with a single dose of intravitreal Bevacizumab and had an excellent response

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