Korean J Ophthalmol.  2009 Jun;23(2):132-134. 10.3341/kjo.2009.23.2.132.

Intravitreal Bevacizumab (Avastin) Treatment of Neovascular Glaucoma in Ocular Ischemic Syndrome

• Lee SJ
• Lee JJ
• Kim SY
• Kim SD

• KMID: 754734
• DOI: http://doi.org/10.3341/kjo.2009.23.2.132

Abstract

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 mmHg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 mg/0.05mL injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 mmHg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.

Keyword

Anti-VEGF; Bevacizumab; Neovascular glaucoma; Ischemic ocular syndrome; Ischemic retinopathy

MeSH Terms

Aged
Angiogenesis Inhibitors/*administration & dosage
Antibodies, Monoclonal/*administration & dosage
Carotid Stenosis/*complications/diagnosis
Diagnosis, Differential
Eye/*blood supply
Fluorescein Angiography
Fundus Oculi
Glaucoma, Neovascular/diagnosis/*drug therapy/etiology
Humans
Injections
Ischemia/*complications/diagnosis
Magnetic Resonance Angiography
Male
Vascular Endothelial Growth Factor A
Vitreous Body

Figure

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  Fig. 1 Slit lamp examination demonstrated 6 clock hours of angle neovascularization with synechiae in the left eye.

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  Fig. 2 (A) Flouorescein angiography revealed hypofluorescence in the choroid and retinal vessels. (B) An MRI showed occlusion of the left carotid artery.

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  Fig. 3 One day after intravitreal injection of bevacizumab, neovascularization of the iris had almost completely resolved.

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