Intravitreal bevacizumab treatment for neovascular glaucoma: histopathological analysis of trabeculectomy specimens

Yoshida, Noriko; Hisatomi, Toshio; Ikeda, Yasuhiro; Kohno, Ri Ichiro; Murakami, Yusuke; Imaki, Hiroyuki; Ueno, Akifumi; Fujisawa, Kimihiko; Ishibashi, Tatsuro

doi:10.1007/s00417-011-1761-2

Cited by 15 publications

(11 citation statements)

References 30 publications

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“…Intravitreal bevacizumab (IVB) was reported to decrease the concentration of VEGF in the aqueous humor [7], the neovascularization of the anterior chamber, and the IOP to acceptable levels in NVG patients [8-12]. Fluorescein angiography and histochemical investigations demonstrated that there was less vascular permeability and inflammatory reaction in trabecular tissue with IVB than without IVB [13,14]. Another histopathological investigation indicated that IVB may induce changes in immature, newly formed vessels, leading to endothelial apoptosis with vascular regression and inducing the normalization of premature vessels in PDR or NVG eyes [15].…”

Section: Introductionmentioning

confidence: 99%

Hyphema is a risk factor for failure of trabeculectomy in neovascular glaucoma: a retrospective analysis

et al. 2014

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BackgroundSeveral retinal ischemic diseases can cause neovascular glaucoma (NVG). Trabeculectomy with mitomycin C (MMC) is a relatively better treatment modality in the management of eyes with NVG than other glaucoma surgeries. The aim of this study was to investigate the factors that may influence the outcome of trabeculectomy with MMC for NVG.MethodsForty-nine NVG eyes from 43 patients (26 males and 17 females) underwent primary trabeculectomy with MMC. The mean follow-up period was 16.8 ± 8.1 months (range, 6 to 34 months). Twenty-one eyes of 21 patients received intravitreal bevacizumab (IVB) 3.6 ± 1.8 days before trabeculectomy with MMC. A Kaplan-Meier survival-curve analysis was used to summarize the cumulative probability of success. We examined the relationship between the surgical outcome and the following surgical factors: gender, age, history of panretinal photocoagulation, history of cataract surgery, history of vitrectomy, preoperative IVB, NVG in the fellow eye, and postoperative complications (hyphema, choroidal detachment, and formation of fibrin) by multivariate analysis.ResultsThe survival rate was 83.7% after 6 months, 70.9% after 12 months, and 60.8% after 24 months. The Kaplan-Meier survival curves showed no significant difference in the survival rate between the eyes with preoperative IVB (n = 21) and the eyes without preoperative IVB (n = 28) (p = 0.14). The multiple logistic regression analysis showed that postoperative hyphema (odds ratio, 6.54; 95% confidence interval, 1.41 to 35.97) was significantly associated with the surgical outcome (p = 0.02).ConclusionsPostoperative hyphema was significantly correlated with the outcome of trabeculectomy for NVG. There was no significant association between preoperative IVB and postoperative hyphema or the results of trabeculectomy.

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Section: Introductionmentioning

confidence: 99%

Hyphema is a risk factor for failure of trabeculectomy in neovascular glaucoma: a retrospective analysis

et al. 2014

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“…In our group, no statistically significant difference was found in the average iris thickness between PRP-treated eyes and nontreated eyes and also between anti-VEGF treated eyes and nontreated eyes. The anti-VEGF injection strongly inhibits vascular permeability [ 14 ] and promotes regression of immature vessels while inducing normalization and maturation of premature vessels [ 15 ]. Further studies should clarify the effect of PRP and the anti-VEGF injection on iris thickness.…”

Section: Discussionmentioning

confidence: 99%

Iris Morphological Features in Patients with 360° Angle-Closure Neovascular Glaucoma: An Anterior Segment Optical Coherence Tomography Study

Kobayashi¹,

Nakakura²,

Terao³

et al. 2018

Case Rep Ophthalmol

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Purpose: To investigate iris morphological features in 360° angle-closure neovascular glaucoma (NVG) by swept-source anterior segment optical coherence tomography (ASOCT). Patients and Methods: In this retrospective, clinic-based, comparative study, 14 patients with 360° angle-closure NVG and 14 healthy age-matched control subjects were enrolled. All patients enrolled had no prior glaucoma surgery but underwent cataract surgery with intraocular lens implantation. Horizontal scanning images of swept-source ASOCT were analyzed using software calipers in temporal and nasal angle areas. The iris thickness at 1 and 2 mm from the pupil edge, iris length, trabecular meshwork length, peripheral anterior synechia (PAS) length, PAS height ratio (PAS length/trabecular meshwork length), and pupil diameter were measured. Results: Between the groups, there were no statistically significant differences in iris length, trabecular meshwork length, and pupil diameter (p > 0.05). However, the iris thickness was significantly reduced in the NVG group compared with the control group in the temporal and nasal areas (0.306 vs. 0.563 mm/0.326 vs. 0.645 mm at 1 mm, 0.278 vs. 0.523 mm/0.282 vs. 0.546 mm at 2 mm, respectively) (mean, all p < 0.001). In the NVG group, PAS height ratios were 1.55 ± 0.45 (mean ± standard deviation) (range, 0.58–2.30) and 1.55 ± 0.78 (range, 0.68–3.68) at the temporal and nasal angles, respectively. Conclusions: In patients with 360° angle-closure NVG, the iris thickness decreased to about 50% of that in healthy subjects, and the PAS length exceeded the trabecular meshwork length by about 1.5 times.

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“…Yoshida et al 25 demonstrated reduced vascular permeability, decreased inflammatory reaction, loss of vascular function and endothelial cell degeneration in trabecular tissues of patients undergoing trabeculectomy for NVG.…”

Section: Conceptmentioning

confidence: 99%

Bevacizumab in Glaucoma: Where do We Stand?

Khanna¹

2012

Journal of Current Glaucoma Practice

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The use of antivascular endothelial growth factors such as bevacizumab and ranibizumab has brought about a revolution in management protocols of various ophthalmic disorders. A lot has been written about these agents, still lacunae exist in our understanding due to paucity of randomized control trials with large number of patients. This brief review attempts to throw light on the clinical applications of these molecules for glaucoma.How to cite this articleKhanna A. Bevacizumab in Glaucoma: Where do We Stand? J Current Glau Prac 2012;6(2):75-78.

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Intravitreal bevacizumab treatment for neovascular glaucoma: histopathological analysis of trabeculectomy specimens

Abstract: The biological effects on angle neovascularization after IVB may involve reduced vascular permeability, decreased inflammatory reaction, loss of vascular function, and endothelial cell degeneration.

Cited by 15 publications

References 30 publications

Hyphema is a risk factor for failure of trabeculectomy in neovascular glaucoma: a retrospective analysis

Hyphema is a risk factor for failure of trabeculectomy in neovascular glaucoma: a retrospective analysis

Iris Morphological Features in Patients with 360° Angle-Closure Neovascular Glaucoma: An Anterior Segment Optical Coherence Tomography Study

Bevacizumab in Glaucoma: Where do We Stand?

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