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

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

scholarly journals Penetration of Bevacizumab into the Iris, Anterior Chamber Angle and Ciliary Body After Intravitreal Injection

2009 ◽  
Vol 03 (01) ◽  
pp. 36
Author(s):  
Swaantje Peters ◽  
Peter Heiduschka ◽  
Karl-Ulrich Bartz-Schmidt ◽  
Ulrich Schraermeyer ◽  
◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Intravitreal Injection ◽  
Ciliary Body ◽  
Anterior Segment ◽  
Intravitreal Bevacizumab ◽  
Neovascular Glaucoma ◽  
Anterior Chamber Angle ◽  
Rubeosis Iridis ◽  
Endothelial Growth Factor ◽  
Chamber Angle

Recently, it was suggested that the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab could be used in the treatment of rubeosis iridis. Therefore, we aimed to trace the penetration of bevacizumab into the anterior chamber after intravitreal injection of the drug. We found that intravitreally injected bevacizumab penetrates well and quickly into the anterior chamber angle, iris and ciliary body. The highest concentration of bevacizumab is present on days one to four after injection, with penetration into the iris appearing to be faster than that into the anterior chamber angle and ciliary body. These findings are consistent with the clinically described regression of iris neovascularisation one to three days after injection. Furthermore, we demonstrated progressive penetration through the tissues of the anterior chamber towards the sclera. Our study showed that the intravitreal application mode is suitable for obtaining an accumulation of bevacizumab throughout the vascularised tissues of the anterior segment. Intravitreal bevacizumab may be used as a supplementary treatment for rubeosis iridis and neovascular glaucoma.

scholarly journals Challenging Management of Neovascular Glaucoma to Achieve the Best Visual Outcome

2020 ◽  
Vol 11 (1) ◽  
pp. 85-91
Author(s):  
Ikhwanuliman Putera ◽  
Astrianda N. Suryono ◽  
Widya Artini
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Neovascular Glaucoma ◽  
Central Vein ◽  
Panretinal Photocoagulation ◽  
Comprehensive Management ◽  
Intravitreal Bevacizumab Injection ◽  
Challenging Situation ◽  
Bevacizumab Injection

Neovascular glaucoma (NVG) resulting from ischemic insults caused by various diseases, such as proliferative diabetic retinopathy and central vein occlusion, remains a challenging situation. This case report aims to describe the complex management of NVG, resulting from diabetic retinopathy, to achieve the best visual outcome. A 47-year-old male presented with poor visual acuity of both eyes. His right eye was inoperable. Ahmed valve implantation with intraoperative intravitreal bevacizumab injection was performed in his left eye. Panretinal photocoagulation was performed serially after phacoemulsification. However, intraocular pressure was found to be raised, thus necessitating 5-fluorouracil needling bleb revision and administration of intracameral bevacizumab injection. During 15 months of follow-up we were able to achieve the best visual outcome possible in this patient. Comprehensive management of NVG should be implemented with a multidisciplinary approach.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

scholarly journals Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up

2014 ◽  
Vol 93 (1) ◽  
pp. e1-e6 ◽  
Author(s):  
Enyr S. Arcieri ◽  
Jayter S. Paula ◽  
Rodrigo Jorge ◽  
Kleyton A. Barella ◽  
Rafael S. Arcieri ◽  
...  
Keyword(s):  
Intravitreal Bevacizumab ◽  
Neovascular Glaucoma ◽  
Efficacy And Safety ◽  
Ahmed Glaucoma Valve ◽  
Valve Implantation ◽  
Ahmed Glaucoma Valve Implantation

The Efficacy of Subconjunctival Bevacizumab in the Management of Rubeosis Iridis and Neovascular Glaucoma

2019 ◽  
Vol 26 (1) ◽  
pp. 18-24
Author(s):  
Khatatbeh , Ahmed E. ◽  
Otoum , Marwan ◽  
Al Zweimel , Fawaz ◽  
Haddad , Hala ◽  
Rwashdeh , Hesham
Keyword(s):  
Neovascular Glaucoma ◽  
Rubeosis Iridis

Refractive and Visual Outcomes after Scleral Fixated Intraocular Lens Implantation in Children with Ectopia Lentis

2020 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Regina Lalramhluni ◽  
Soveeta Rath ◽  
Ankita Shrivastav ◽  
Prem Kumar Singh ◽  
Rahul Mayor ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Visual Outcome ◽  
Ectopia Lentis ◽  
Corrected Visual Acuity ◽  
Good Visual Outcome ◽  
Induced Astigmatism ◽  
The Mean ◽  
The Stability ◽  
Scleral Fixated Intraocular Lens

Introduction: This study was conducted to report the refractive and visual outcome after Scleral Fixated Intraocular Lens (SFIOL) implantation in children with nontraumatic ectopia lentis. Methods: Retrospective review of the medical records of 25 eyes of 15 patients who underwent SFIOL implantation in children with non-traumatic ectopia lentis. Results: The mean best corrected visual acuity (BCVA) before SFIOL implantation was 1.07 ± 0.9 logMar units [median: 0.9, Interquartile range (ΙQR): 0.415 to 1.555] which improved to 0.41 ± 0.33 logMar units (median: 0.22, ΙQR: 0.180 to 1.555) at two months postoperative follow up. In phakic group, the mean spherical refraction preoperatively was -12.04 ± 7.82 DS (dioptre sphere) (IQR: +16 to -5.875) and postoperatively was +0.93 ± 2.67DS (IQR: -0.375 to +2). In aphakic group, the mean spherical refraction preoperatively was +12.22 ± 2.05 DS and postoperatively was +1.2 ± 1.9 DS. The mean total astigmatism preoperatively was -6.44 ± 4.95 DC (dioptre cylinder) (median: 6, IQR: -10.50 to +2) and postoperatively was -1.47 ± 0.98 DC (median: -1.5, IQR: -2 to - 0.625 ). The mean IOL induced astigmatism was -1.01 ± 0.95 DC (median -0.75, IQR: -1.33 to - 0.25). The spherical refractive equivalent was within 2 Diopter (D) of the target refraction calculated preoperatively in 20 eyes and in five eyes it was more than 2 D. Conclusion: SFIOL implantation is associated with good visual outcome with a significant improvement in the refractive error. However, a longer follow up is required to assess the change of refraction and the stability of the SFIOL.

scholarly journals Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Faried Mohammed Wagdy ◽  
Adel Galal Zaky
Keyword(s):  
Previous History ◽  
Visual Outcome ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
History Of ◽  
Therapeutic Tools ◽  
Endothelial Growth Factor ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Purpose. To compare the outcomes of Ex-PRESS glaucoma filtration device and transscleral cyclophotocoagulation (TSCP) in the management of neovascular glaucoma (NVG). Patients and Methods. A total of 30 eyes (12 express shunts and 18 TSCP) of 28 patients were included. The eyes had NVG with intraocular pressure (IOP) more than 21 mmHg of the maximally tolerated medication treatment after previous panretinal photocoagulation and antivascular endothelial growth factor (anti-VEGF) injection, with no previous history of a cyclodestruction procedure or glaucoma surgery, were randomized either for Ex-PRESS glaucoma filtration device or TSCP. The patients were followed up weekly for the first month and then monthly for 12 months as regard to the IOP, number of topical antiglaucoma drugs required, visual outcome, and postoperative complications. Results. IOP was successfully controlled with both techniques in 83.3% of the eyes. Both techniques had fewer complications and required fewer subsequent procedures. Conclusion. Both the Ex-PRESS glaucoma filtration device and TSCP might constitute safe and alternative therapeutic tools for patients with NVG. However, TSCP is an easier procedure, less time consuming, and does not require a learning curve.

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