Intravitreal Bevacizumab in the treatment of neovascular glaucoma secondary to central retinal vein occlusion: a case report

PURPOSE To report the effect of an intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab (IVB) as symptomatic treatment for neovascular glaucoma. PATIENTS AND METHOD This prospective study included 13 eyes of 12 patients presenting neovascular glaucoma, in two cases secondary to ischemic central retinal vein occlusion and, in ten cases, to proliferative diabetic retinopathy. Each patient received an intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab, in combination with other procedures such as panretinal photocoagulation to treat retinal ischemia and transscleral cyclocryoapplication as glaucoma treatment. Their mean age was 58 years (range, 35-75 years). The mean intraocular pressure (IOP) was 40 mmHg+/-10 mmHg. The mean follow-up was 6 months. RESULTS IVB resulted in a marked regression of anterior segment neovascularization and relief of symptoms within 48 h. IOP decreased substantially in eight eyes; in four eyes, adjuvant cyclocryoapplication was necessary. The last eye was affected by a retinal detachment 1 month after IVB. No side effects were observed. DISCUSSION We observed that the intravitreal injection of bevacizumab enabled the total regression of iris and angle neovascularization but had only a partial action on intraocular hypertension. CONCLUSION Intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab contributes to a better management of neovascular glaucoma.