Intravitreal Bevacizumab as an Adjunct Treatment for Neovascular Glaucoma

Purpose To assess the effect of adjunctive intravitreal bevacizumab treatment on neovascular glaucoma (NVG). Methods The medical records of all consecutive patients with NVG treated with intravitreal bevacizumab at our center from May 2006 to February 2008 were reviewed. The data collected included background features, findings on full ophthalmologic examination (including visual acuity, gonioscopy, and intraocular pressure), glaucoma medications prescribed, and additional procedures for glaucoma performed before and after bevacizumab injection. The interval between the diagnosis of NVG and intravitreal bevacizumab treatment was calculated. Results Eighteen patients (6 male, 12 female; mean age 63±13.2 years) met the study criteria. Causes of NVG were proliferative diabetic retinopathy (n=14), central retinal vein occlusion (n=2), occlusive vasculitis (n=1), and panuveitis (n=1). The mean duration of follow-up was 52 (±12) weeks. Mean intraocular pressure decreased from 32.3 (±4.99) to 18 (±6.1) mmHg (p<0.0001) and mean number of glaucoma medications decreased from 3.16 (±1.2) to 2.55 (±1.46) (p=0.1938). An interval of less than 6 months between the start of bevacizumab treatment and diagnosis was associated with better final visual acuity than delayed treatment (0.82±0.4 logMAR vs 1.88±1.1 logMAR, p=0.002) and a better regression of iris neovascularization (22% vs 89%; p=0.015). Conclusions Intravitreal bevacizumab is beneficial for the treatment of anterior segment neovascularization and NVG when used as an adjunct, making the administration of additional treatment for the underlying cause possible. Bevacizumab should be instituted promptly after diagnosis, before irreversible anatomic and functional damage occurs.

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STUDY CLINICAL FEATURE AND RESULT OF TREATMENT PHACOMORPHIC GLAUCOMA

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2015.1.9 ◽

2015 ◽

pp. 71-75

Author(s):

Van Nam Phan ◽

Ba Ken Tran

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Statistical Significance ◽

Corneal Edema ◽

Clinical Feature ◽

Anterior Chamber Angle ◽

Male Population ◽

Significant Difference ◽

Operative Complications ◽

Before And After

Purpose: Study clinical feature of phacomorphic glaucoma. To evaluate the result of treatment phacomorphic glaucoma. Method: The retrospective, interventional study on 36 cases with phacomorphic glaucoma who underwent treated at Hue Central Hospital from 6/2010 to 6/2011. Standard of research: visual, IOP, before and after surgery, accompanying lesions and post-operative complications. The surgery is considered successful when postoperative IOP less than 21 mmHg. Results: Age 50-59 presented 30.5 percent, ≥ 60 presented 91.7 percent. There was a slight female preponderance (66.7%) compared to the male population (33.3%) which implies a statistically marginally significant difference. However there was no statistical significance difference when compared by the two subgroups. Patient in country presented 61,1% and city presented 38,9%. The duration between the onset of pain and surgery from 0 to < 5 days (77.8%), from 6 to 10 (16.7%) and >10 days presented 5.5%. The preoperative intraocular pressure 35 to 45mmHg (47.2%), 46-55 (30.6%), 56-65 (13.9%) and more than 65 presented 8.3%. The visual acuity preoperation less than 1metre count finger (94.5%), less than 3 metre count finger presented 5.5%. Close anterior chamber angle presented 80.6% and shallow was presented 19.4%. Corneal edema presented 100%, iritis presented 94.4%, dilated pupil larger 5mm presented 83.3%, Synchynea iris and cataract presented 72.2%. ECCE, implantation IOL combined trabeculectomy presented 11.1%, Phaco, implantation IOL combined trabeculectomy presented 69,5%, ECCE implantation IOL presented 5.6%, Phaco, implantation IOL presented 13.8%. Postoperative visual acuity from 1/10 to 5/10 presented 72.2%, no case have VA larger than 5/10. Postoperative 3 months VA 1/10 to 5/10 presented 72.2%, larger VA 5/10 presented 8.3%. Postoperative 3 months intraocular pressure ≤ 21mmHg presented 91.7%, 22 to 24mmHg presented 8.3%, no case have IOP ≥25mmHg. Postoperative edema presented 58.3%, iritis presented 58.3%. Key words: phacomorphic Glaucoma

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Morphological changes in the trabecular meshwork and Schlemm’s canal after treatment with topical intraocular pressure-lowering agents

Scientific Reports ◽

10.1038/s41598-021-97746-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ji-Hye Park ◽

Hyun Woo Chung ◽

Eun Gyu Yoon ◽

Min Jung Ji ◽

Chungkwon Yoo ◽

...

Keyword(s):

Intraocular Pressure ◽

Trabecular Meshwork ◽

Morphological Changes ◽

Open Angle Glaucoma ◽

Anterior Segment ◽

Schlemm’S Canal ◽

Schlemm's Canal ◽

Before And After ◽

Treatment Naïve ◽

Aqueous Outflow

AbstractGlaucoma treatment is usually initiated with topical medication that lowers the intraocular pressure (IOP) by reducing the aqueous production, enhancing the aqueous outflow, or both. However, the effect of topical IOP-lowering medications on the microstructures of the aqueous outflow pathway are relatively unknown. In this retrospective, observational study, 56 treatment-naïve patients with primary open-angle glaucoma were enrolled. Images of the nasal and temporal corneoscleral limbus were obtained using anterior segment optical coherence tomography (AS-OCT). The conjunctival vessels and iris anatomy were used as landmarks to select the same limbal area scan, and the trabecular meshwork (TM) width, TM thickness, and Schlemm’s canal (SC) area were measured before and after using the IOP-lowering agents for 3 months. Among the 56 patients enrolled, 33 patients used prostaglandin (PG) analogues, and 23 patients used dorzolamide/timolol fixed combination (DTFC). After 3 months of DTFC usage, the TM width, TM thickness, and SC area did not show significant changes in either the nasal or temporal sectors. Conversely, after prostaglandin analog usage, the TM thickness significantly increased, and the SC area significantly decreased (all P < 0.01). These findings warrant a deeper investigation into their relationship to aqueous outflow through the conventional and unconventional outflow pathways after treatment with PG analogues.

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Examining the effect and safety of orthokeratology in controlling the development of myopia: Based on fluorosilicone acrylic breathable material

Materials Express ◽

10.1166/mex.2020.1690 ◽

2020 ◽

Vol 10 (5) ◽

pp. 740-747

Author(s):

Yanxia Song ◽

Haixia Tian ◽

Suling Yang ◽

Feifan Du ◽

Huihui Sun ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Axial Length ◽

Corneal Endothelium ◽

Clinical Effect ◽

Naked Eye ◽

Corrected Visual Acuity ◽

Significant Difference ◽

Before And After

We aimed to evaluate the clinical effect and safety of orthokeratology in controlling the development of myopia. We assessed the changes in visual acuity, diopter change, axial length, corneal endothelium count, intraocular pressure, and corneal Q value in 30 adolescents with 60 years of wearing an orthokeratology lens. In this study, no significant difference was observed between the naked eye vision and corrected visual acuity before wearing the lens (t = –0.23, P = 0.59); furthermore, no significant difference was observed in diopter, axial length, corneal endothelium count, and intraocular pressure 1 year before and after wearing the lens (t = 1.24, P = 0.45; t = –0.89, P = 0.25; t = –0.43, P = 0.57; t = 1.43, P = 0.61); by contrast, there was a significant difference in the corneal Q value before and after wearing the lens (t = –8.37, P = 0.001). These results suggest that the fluorosilicone acrylic breathable material corneal orthopedic lens is safe and effective in controlling myopia, and has little effect on the physiology of the eye.

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Single-pass four-throw pupilloplasty for Urrets-Zavalia syndrome

European Journal of Ophthalmology ◽

10.1177/1120672117747038 ◽

2018 ◽

Vol 28 (5) ◽

pp. 552-558 ◽

Cited By ~ 1

Author(s):

Priya Narang ◽

Amar Agarwal ◽

Dhivya Ashok Kumar

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Segment ◽

Anterior Chamber Angle ◽

Single Pass ◽

Corrected Visual Acuity ◽

The Mean ◽

Chamber Angle ◽

Best Corrected Visual Acuity

Purpose: To demonstrate the efficacy and initial results of single-pass four-throw pupilloplasty in cases of Urrets-Zavalia syndrome. Methods: In this prospective interventional study, single-pass four-throw was performed to reconstruct the pupil in all symptomatic cases with Urrets-Zavalia syndrome. Applanation tonometry, indentation gonioscopy, and anterior segment optical coherence tomography for anterior chamber angle assessment were performed in all the cases. Results: Out of 10 cases that were identified with Urrets-Zavalia syndrome, the procedure was performed in 7 cases, whereas 3 cases were left untreated, as they did not have any visual complaints. Five out of seven eyes had preoperative raised intraocular pressure with appositional closure of the angle. Postoperatively, intraocular pressure was controlled in all the eyes, whereas one eye required antiglaucoma medications to control the intraocular pressure. The mean preoperative and postoperative best-corrected visual acuity was 1.1 ± 1.2 and 0.4 ± 0.4 LogMar, respectively. There was a significant improvement in the best-corrected visual acuity (p = 0.0169) in the postoperative period. The mean preoperative and postoperative intraocular pressure was 26.6 ± 11.23 and 16.3 ± 2.98 mm Hg, respectively (p = 0.0168). All the patients had a minimum of 6-month follow-up period (range = 6–8 months). Conclusion: Single-pass four-throw can be employed for cases with Urrets-Zavalia syndrome, and single-pass four-throw helps to prevent the postoperative glare and narrows down the pupil size effectively. Single-pass four-throw helps to alleviate the anterior chamber angle apposition in patients with Urrets-Zavalia syndrome by mechanically pulling the peripheral iris centrally as demonstrated on anterior segment optical coherence tomography. The study also reports the occurrence of Urrets-Zavalia syndrome after glued intraocular lens surgery.

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Single-pass four-throw pupilloplasty for secondary angle-closure glaucoma associated with silicon oil tamponade

European Journal of Ophthalmology ◽

10.1177/1120672118780809 ◽

2018 ◽

Vol 29 (5) ◽

pp. 561-565 ◽

Cited By ~ 1

Author(s):

Priya Narang ◽

Ashar Agarwal ◽

Amar Agarwal

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Chamber ◽

Anterior Segment ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Single Pass ◽

Silicon Oil ◽

The Mean

Purpose: To describe the feasibility and efficacy of performing single-pass four-throw pupilloplasty for secondary angle-closure glaucoma post silicon oil tamponade. Methods: The procedure was performed in five eyes of five patients. All the cases underwent silicon oil removal with single-pass four-throw pupilloplasty. Single-pass four-throw procedure involves a single pass of needle through the iris tissue that is to be apposed followed by taking four throws by passing the suture end through the loop that is withdrawn from the anterior chamber as in a modified Siepser’s slip-knot technique. Both the suture ends are pulled and this leads to sliding of the loop into the anterior chamber. Surgical pupilloplasty stretches the peripheral iris tissue and helps in breaking the peripheral anterior synechia. Intraoperative gonioscopy and anterior segment optical coherence tomography were performed in all the cases. Results: Intraoperative gonioscopy and anterior segment optical coherence tomography demonstrated opening of the anterior chamber angles with breakage of peripheral anterior synechia. The mean preoperative and postoperative best-corrected visual acuity in logarithm of minimum angle of resolution was 1.24 ± 0.23 and 0.56 ± 0.18, respectively (p < 0.001). The mean preoperative and postoperative intraocular pressure was 38.2 ± 4.97 and 13.0 ± 2.35 mm Hg, respectively. There was a significant decrease in intraocular pressure and marked improvement in visual acuity in all the cases. Conclusion: Surgical pupilloplasty helps to relieve the post-silicon oil-induced secondary angle-closure glaucoma by breaking peripheral anterior synechia and significantly opening the anterior chamber angles.

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INTRAVITREAL BEVACIZUMAB TREATMENT FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION WITH GOOD VISUAL ACUITY

Retina ◽

10.1097/iae.0b013e31825db771 ◽

2012 ◽

Vol 32 (9) ◽

pp. 1811-1820 ◽

Cited By ~ 8

Author(s):

Ruth Axer-Siegel ◽

Elite Bor ◽

Dan H. Bourla ◽

Dov Weinberger ◽

Karin Mimouni

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Good Visual Acuity ◽

Age Related ◽

Bevacizumab Treatment

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Evaluation of Outflow StructuresIn Vivoafter the Phacocanaloplasty

Journal of Ophthalmology ◽

10.1155/2016/4519846 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Daiva Paulaviciute-Baikstiene ◽

Renata Vaiciuliene ◽

Vytautas Jasinskas ◽

Ingrida Januleviciene

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Anterior Segment ◽

Open Angle ◽

Glaucoma Medication ◽

Postoperative Visual Acuity

Purpose. To evaluate thein vivochanges in Schlemm’s canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT).Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery.Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) (p<0.05) mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2versus 5098.8 (1190.5) μm2,p<0.001) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm,p=0.001) after surgery. We found negative correlations between SC area and IOP before surgery (r=-0.67,p=0.03) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (r=-0.80,p=0.005).Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease.

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Outcomes of a Foldable Capsular Vitreous Body Implantation: A Retrospective Study

Disease Markers ◽

10.1155/2021/6575195 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Xiangzhong Xu ◽

Huimin Ge ◽

Jiajun Li ◽

Weihong Shang ◽

Yuke Ji ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Chamber ◽

Ocular Trauma ◽

Silicone Oil ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Vitreous Body ◽

Fundus Photography ◽

Clinical Value

Background. The vitreous body is an important part of the ocular body fluid. A foldable capsular vitreous body (FCVB) is designed to treat chronic adverse complications in severe ocular trauma and silicone oil-dependent eyes. This study is aimed at investigating a method for implanting an FCVB, its postoperative efficacy, and clinical value. Methods. A retrospective analysis was performed on data from 18 patients who underwent vitrectomy and FCVB implantation for severe ocular trauma and silicone oil-dependent eyes between March 2019 and May 2020. All treated eyes underwent clinical examinations involving the best-corrected visual acuity, intraocular pressure, FCVB position, anterior segment photography, and wide-angle fundus photography regularly after surgery. Results. Eighteen eyes from 18 patients were enrolled in this study. A total of 2.00–4.20 ( 3.46 ± 0.78 ) ml of silicone oil were injected into the FCVB during surgery. The patients were followed up at 1, 2, and 4 weeks and 3, 6, and 12 months after surgery. Twelve months after surgery, visual acuity improved in 7 (38.89%) eyes. In contrast, 10 (55.56%) eyes showed no obvious improvement, and 1 (5.56%) eye had decreased vision. Intraocular pressure at 12 months was 10.13 ± 3.52 mmHg, which was comparable to that before the surgery ( t = 0.38 , P = 0.71 ). The anterior chamber depth examined by slit lamp was 2.00–3.00 cornea thickness (CT) in 7 eyes, 1.00–2.00 CT in 2 eyes, and <1.00 CT in one eye. The anterior chamber disappeared in eight eyes. There were eight eyes with clear cornea, four eyes with localized opacity, and two eyes with obvious gray-white opacity. There was no case of severe FCVB deflection, rupture, or exposure during the observation period. Conclusion. FCVB implantation is an effective and safe treatment for eyes with severe ocular trauma and silicone oil-dependent eyes. It may support retinal reattachment, slow down eyeball atrophy, reduce the risk of chronic adverse complications such as corneal endothelial decompensation, and maintain intraocular pressure and preoperative visual function.

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Neovascular Glaucoma after Diabetic Vitrectomy: Incidence and Risk Factors

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.7.963 ◽

2021 ◽

Vol 62 (7) ◽

pp. 963-968

Author(s):

Hyeon Woo Son ◽

Jung Min Park ◽

Myeong In Yeom

Keyword(s):

Risk Factors ◽

Anterior Segment ◽

Significant Risk ◽

Intravitreal Bevacizumab ◽

Neovascular Glaucoma ◽

Panretinal Photocoagulation ◽

Close Monitoring ◽

Diabetic Vitrectomy ◽

Postoperative Findings ◽

High Possibility

Purpose: The prevalence and risk factors of neovascular glaucoma (NVG) after diabetic vitrectomy were evaluated. Methods: This retrospective study included 171 eyes of 141 patients who underwent diabetic vitrectomy in-hospital between March 2013 and July 2019 and were followed for >12 months postoperatively. Regardless of the presence or absence of neovascularization in the anterior segment, all patients received injections of intravitreal bevacizumab during vitrectomy. Patients with preoperative neovascularization in iris (NVI) or angle (NVA) received both intracameral and intravitreal bevacizumab injections. Data were collected regarding baseline demographics, preoperative best-corrected visual acuity, intraocular pressure, hypertension, NVG in the fellow eye, panretinal photocoagulation history, iris and angle neovascularization, and postoperative findings (e.g., rebleeding and residual retinal detachment). Results: In total, 141 patients and 171 eyes were included in the study, and the incidence of postoperative NVG was 5.85% (10 patients). Five patients (27.78%) with preoperative NVI or NVA developed postoperative NVG. Significant risk factors for postoperative NVG were preoperative NVA or NVI (odds ratio [OR] = 16.428, p = 0.003), shorter diabetic duration (OR = 0.853, p = 0.033), and the absence of preoperative panretinal photocoagulation (OR = 0.006, p = 0.035). Conclusions: There is a high possibility of postoperative NVG in patients with preoperative NVI or NVA, a short duration of diabetes, and no preoperative panretinal photocoagulation. In such patients, close monitoring is required after diabetic vitrectomy.

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Comparison of Visual Acuity and Central Macular Thickness in Neovascular Age-related Macular Degeneration Patients with Subretinal and Intraretinal Fluid Treated with Intravitreal Bevacizumab

Ophthalmologica Indonesiana ◽

10.35749/journal.v45i1.173 ◽

2019 ◽

Vol 45 (1) ◽

pp. 20

Author(s):

Novia Rahayu ◽

Elvioza Elvioza ◽

Aria Kekalih

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Loading Dose ◽

Central Macular Thickness ◽

Neovascular Amd ◽

Age Related ◽

Bevacizumab Treatment ◽

Intraretinal Fluid

Purpose: To compare visual acuity (VA) and central macular thickness (CMT) outcome of loading dose intravitreal bevacizumab treatment between neovascular AMD patients with character of predominant subretinal and intraretinal fluid. Methods: Prospective study of loading dose intravitreal bevacizumab treated age-related macular degeneration, of which has a baseline macular morphology of subretinal or intraretinal fluid. VA, CMT, and their changes were evaluated during and after loading dose was completed. Results: Thirty eight eyes (38 patients, mean age 66,95 years) were enrolled. 20 eyes were in subretinal fluid (SRF group) and 18 intraretinal fluid (IRF) group. Mean VA at baseline eventually was significantly different where SRF group (56,41 letters) were better than IRF group (43,72 letters). No statistically significant difference of mean VA change or CMT change between group, however VA in SRF group remained higher and CMT in SRF group were lower than IRF group. Conclusion: Neovascular AMD, with both SRF and IRF at baseline, benefits from loading dose intravitreal bevacizumab treatment although mean visual acuity and mean central retinal thickness are better in those with SRF.

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