Intravitreal Ranibizumab As Adjuvant Treatment For Neovascular

The purpose of this study was to describe a prospective case series of 5 eyes treated with intravitreal ranibizumab injection for neovascular glaucoma (NVG). Five patients with clinically uncontrolled NVG secondary to proliferative diabetic retinopathy (4 patients) and central retinal vein occlusion (1 patient), non-responsive to maximal tolerable medication and panretinal photocoagulation, received intravitreal ranibizumab injection (0.5 mg). Patients were seen at 1st, 3rd and 7th day after the ranibizumab injection and when it was necessary. Success was defined as intraocular pressure (IOP) 21, despite maximal tolerable medication, underwent trabeculectomy with 0.5mg/ml mitomycin C (MMC) for 1 minute. Failure was defined as IOP > 21 mmHg, phthisis bulbi, loss of light perception or additional glaucoma surgery. The primary outcome was 6-month IOP control. Mean IOP before the ranibizumab injection was 37 mmHg (7 mmHg SD). Two out of five eyes underwent only ranibizumab injection, having an IOP control after the procedure. Three patients were submitted to trabeculectomy with MMC on the 7th day after the injection. At 6-month follow-up, the mean IOP was 12mmHg (3 mmHg SD). All eyes showed regression of rubeosis iridis and IOP control. Visual acuity improved in 2 eyes worsened in 1 eye, and remained stable in 2 eyes. These data suggest that intravitreal ranibizumab injection may be a useful tool in the treatment of NVG.722119121Allingham, R.R., Damji, K.F., Freedman, S., Moroi, S.E., Shafranov, G., (2005), pp. 328-46. , Shields textbook of glaucoma. 5th ed. Philadelphia, PA: Lippincott Williams & WilkinsParrish, R., Hershler, J., Eyes with end-stage neovascular glaucoma.Natural history following successful modified filtering operation (1983) Arch Ophthalmol, 101 (5), pp. 745-6Beutel, J., Peters, S., Lüke, M., Aisenbrey, S., Szurman, P., Spitzer, M.S., Yoeruek, E., Bevacizumab Study Group, Grisanti S. Bevacizumab as adjuvant for neovascular glaucoma (2010) Acta Ophthalmol, 88 (1), pp. 103-9. , Comment in Acta Ophthalmol. 2010;88(4):e133Douat, J., Auriol, S., Mahieu-Durringer, L., Ancèle, E., Pagot-Mathis, V., Mathis, A., [Intravitreal bevacizumab for treatment of neovascular glaucoma. Report of 20 cases] (2009) J Fr Ophtalmol, 32 (9), pp. 652-63Saito, Y., Higashide, T., Takeda, H., Ohkubo, S., Sugiyama, K., Beneficial effects of preoperative intravitreal bevacizumab on trabeculectomy outcomes in neovascular glaucoma (2010) Acta Ophthalmol, 88 (1), pp. 96-10