Use of Anti-VEGF Agents in Glaucoma Surgery

Slabaugh, Mark A.; Salim, Sarwat

doi:10.1155/2017/1645269

Cited by 21 publications

(20 citation statements)

References 52 publications

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“…Patients with RI commonly express high VEGF levels as a consequence of the underlying PR [ 4 , 9 , 10 ]. Nonetheless, the puncture-induced RI mouse model previously established by us has been demonstrated to be independent of VEGF signaling [ 19 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Gaining insight on mitigation of rubeosis iridis by UPARANT in a mouse model associated with proliferative retinopathy

et al. 2020

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Proliferative retinopathies (PR) lead to an increase in neovascularization and inflammation factors, at times culminating in pathologic rubeosis iridis (RI). In mice, uveal puncture combined with injection of hypoxia-conditioned media mimics RI associated with proliferative retinopathies. Here, we investigated the effects of the urokinase plasminogen activator receptor (uPAR) antagonist—UPARANT—on the angiogenic and inflammatory processes that are dysregulated in this model. In addition, the effects of UPARANT were compared with those of anti-vascular endothelial growth factor (VEGF) therapies. Administration of UPARANT promptly decreased iris vasculature, while anti-VEGF effects were slower and less pronounced. Immunoblot and qPCR analysis suggested that UPARANT acts predominantly by reducing the upregulated inflammatory and extracellular matrix degradation responses. UPARANT appears to be more effective in comparison to anti-VEGF in the treatment of RI associated with PR in the murine model, by modulating multiple uPAR-associated signaling pathways. Furthermore, UPARANT effectiveness was maintained when systemically administered, which could open to novel improved therapies for proliferative ocular diseases, particularly those associated with PR. Key messages • Further evidence of UPARANT effectiveness in normalizing pathological iris neovascularization. • Both systemic and local administration of UPARANT reduce iris neovascularization in a model associated with proliferative retinopathies. • In the mouse models of rubeosis iridis associated with proliferative retinopathy, UPARANT displays stronger effects when compared with anti-vascular endothelial growth factor regimen.

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Section: Discussionmentioning

confidence: 99%

Gaining insight on mitigation of rubeosis iridis by UPARANT in a mouse model associated with proliferative retinopathy

et al. 2020

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“…GDD combined with preoperative anti-VEGF agents injection would help maintain residual visual acuity but not improve the long-term surgical success rate,[ 20 21 ] although changes in bleb vascularity have been reported. [ 22 ] Unfortunately, these injections in patients, that lack proper primary prevention, are temporary measures. There are also reports of subconjunctival injection of bevacizumab for use in rescuing failing filtering blebs; however, the effects have not been corecognized, and the standardization of administration needs to be defined/investigated if effective.…”

Section: Management Of Neovascular Glaucomamentioning

confidence: 99%

“…One thing should be mentioned is VEGF has several roles in physiological process such as VEGF 165 and VEGF 121 more directly affect angiogenesis while the isomer VEGF 189 has more of an impact on fibrosis, and some other subtypes regulate conventional outflow facility. [ 22 23 24 ] So that, different subtypes of VEGF and differential affinity of various anti-VEGF agents may someday be exploited further according to diverse treating goals.…”

Section: Management Of Neovascular Glaucomamentioning

confidence: 99%

Neovascular glaucoma: Handling in the future

Yang

Sun

2018

Taiwan J Ophthalmol

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Neovascular glaucoma (NVG), which is refractory to both medical management and surgical intervention, is a disastrous ocular disease for it always ends up with intolerable pain and extinguishing patients' residual visual function. Since insufficient acknowledge of the pathophysiological and molecular mechanisms of NVG, it has been laying a challenging dilemma of managing NVG in clinical practice for a long time. Along with the progression on some new agents and surgical options targeting certain possible roles in the NVG process, there seems having been some new sights but still much unknown and to be revealed. This review discusses the underlying etiologic diseases of NVG, molecular findings and characteristics of its pathogenic process, as well as the management of NVG in detail. In addition, here represents some of our hypothesis regarding the interesting findings about NVG in clinical practice, aiming to provide some new enlightenment for future research.

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“…These anti-VEGF agents have been widely used not only in NVG but also for wound healing response in traditional glaucoma surgery 5 . Literature shows the direct effect of these injections in inflammatory glaucoma 6 . Anti-vascular endothelial growth factor injections are increasingly used in the treatment of rubeosis and neovascular glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Intracameral Bevacizumab versus Subconjunctival Bevacizumab in the Treatment of Neovascular Glaucoma

Sultan¹,

Siyal²,

Waris³

et al. 2020

pak J Ophthalmol

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Purpose: To compare the effect of intracameral Bevacizumab with sub-conjunctival Bevacizumab in the treatment of neovascular glaucoma. Study Design: Quasi Experimental study. Place and Duration of Study: This study was conducted at Civil hospital Karachi, Pakistan from September 2017 to October 2018. Material and Methods: Patients with intractable Neo-vascular glaucoma visiting the outpatient department of civil hospital, Karachi were included in the study and followed up for 8 months. Patients with sulcus or scleral fixation IOLs and those who were treated with vitreoretinal surgeries were excluded. Patients were divided into two groups. Group A included patients treated with intracameral Bevacizumab and in group B, patients treated with sub-conjunctival Bevacizumab were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and neovascularization of the iris (NVI) were compared between the two groups. Results: Thirty-eight eyes were included in the study; 24 (56.7%) right eyes and 14 (43.3%) left eyes. Most of the patients were males with mean age of 54.53 ± 7.2 years. Mean total injection/eye was 3.45 ± 1.73 in group A and 3.12 ± 2.10 in group B. Pre-injection BCVA (log MAR) was 0.48 ± 0.32 in group A and 0.34 ± 0.32 in group B. At 8 months, BCVA was 1.7 ± 0.2 in group A and 0.48 ± 0.34 in group B which were statistically significant. Pre-injection IOP (mmHg) was 48.9 ± 1.8 in group A and 47.34 ± 1.8 in group B. Post-injection IOP was 28.7±0.8 in group A (p = 0.001) and 34.2 ± 3.4 in group B (p = 0.11) at eight months. Conclusion: This study demonstrates that intracameral Bevacizumab significantly improves BCVA and controls IOP in neovascular glaucoma. However, sub-conjunctival Bevacizumab significantly improves BCVA but decrease in IOP is not statistically significant.

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Use of Anti-VEGF Agents in Glaucoma Surgery

Cited by 21 publications

References 52 publications

Gaining insight on mitigation of rubeosis iridis by UPARANT in a mouse model associated with proliferative retinopathy

Gaining insight on mitigation of rubeosis iridis by UPARANT in a mouse model associated with proliferative retinopathy

Neovascular glaucoma: Handling in the future

Intracameral Bevacizumab versus Subconjunctival Bevacizumab in the Treatment of Neovascular Glaucoma

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