scholarly journals Use of Anti-VEGF Agents in Glaucoma Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mark Slabaugh ◽  
Sarwat Salim
Keyword(s):  
Anterior Segment ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Delivery Methods ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Process Use ◽  
Anti Vegf ◽  
Repeated Use ◽  
Endothelial Growth Factor

A number of antivascular endothelial growth factor agents are currently available to treat various ocular conditions. These agents have similar, but distinct, biologic qualities and have been explored in the management of neovascular glaucoma and in glaucoma surgery. Several different delivery methods are described, and because these medications are routinely given as intraocular injections, some benefits over traditional antifibrotic medications when used in glaucoma surgery are noted. These agents effectively induce regression of anterior segment neovascularization and facilitate initial surgical management of neovascular glaucoma, but the long-term outcome of this condition remains dependent on definitive management of the underlying process. Use in trabeculectomy or tube shunt procedures for other types of glaucoma has shown promise in modulating bleb morphology but has not yet been found to be as effective as traditional antifibrotic agents. There are reports of persistently raised intraocular pressure after repeated use of the anti-VEGF agents, possibly related to frequency of injection. These medications have wide application in the field of surgical glaucoma, but a definitive role has yet to be defined.

scholarly journals Role of Anti-VEGF (Bevacizumab) in Management of Neovascular Glaucoma: A Review

2021 ◽  
pp. 215-221
Author(s):  
Abdulrahman Arshed N. Alharfy ◽  
Marwan Saleh D. Albalawi ◽  
Abdulmajeed Mousa Alzahrani ◽  
Ruby Naif M. Alsubaie ◽  
Amani Ahmad S. Albalawi ◽  
...  
Keyword(s):  
Growth Factor ◽  
Anterior Segment ◽  
Neovascular Glaucoma ◽  
Age Related Macular Degeneration ◽  
Anti Vegf ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor ◽  
Extensive Clinical Experience ◽  
Rapid Regression

Neovascular glaucoma (NVG) is an aggressive type of glaucoma, which often results in poor visual outcomes. Antivascular endothelial growth factor is frequently used for various conditions in which VEGF release is induced in response to retinal ischemia. Bevacizumab is a humanized anti-VEGF monoclonal IgG1 antibody. The potential of antivascular endothelial growth factor (anti-VEGF) agents to modify the disease course of neovascular glaucoma (NVG) was recognized shortly after their use in the treatment of age-related macular degeneration was reported. These medications were noted to induce rapid regression of the anterior segment neovascularization that characterizes NVG. Several studies as well as extensive clinical experience have demonstrated a rapid regression of anterior segment neovascularization following the injection of anti-VEGF agents. This review aims to summarize current evidences regarding effectiveness of Bevacizumab in management of neovascular glaucoma.

scholarly journals Long Term Outcome and Histologic Findings of a Retinal Astrocytic Hamartoma Treated with Intravitreal Injection of Anti-VEGF: A Case Report

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kinza T. Ahmad ◽  
Hana A. Mansour ◽  
Benjamin T. Rollins ◽  
Sergio Pina Oviedo ◽  
Paul H. Phillips ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Subependymal Giant Cell Astrocytoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Anti Vegf ◽  
Histopathologic Evaluation ◽  
Progressive Growth ◽  
Astrocytic Hamartoma

Background. To our knowledge, this is the first report to describe the histologic changes of a retinal astrocytic hamartoma (RAH) in a patient with tuberous sclerosis complex (TSC) treated with antivascular endothelial growth factor (anti-VEGF), as well as the longest anti-VEGF treatment that such a patient has received (3 years). Case Presentation. We present a case of a 20-year-old female with TSC who developed progressive growth of a papillary astrocytic hamartoma that caused significant retinal edema, vitreous hemorrhage, and neovascular glaucoma. The patient was initially treated with 25 intravitreal anti-VEGF injections about every 1-3 months, but eventually developed a blind painful eye from neovascular glaucoma. Histopathologic evaluation of the enucleated globe showed a peculiar difference of the tumor according to its topography, with features reminiscent of pilocytic astrocytoma at the optic nerve head and features reminiscent of subependymal giant cell astrocytoma at the retrolaminar optic nerve. We hypothesize that these changes occurred as a secondary effect of the anti-VEGF treatment. Conclusions. Anti-VEGF agents may decrease the ophthalmologic complications of RAH. We recommend that this treatment should be started early and continued for a protracted time at regular and frequent intervals. Moreover, a combination of therapies might prove to be superior to monotherapy and should therefore be considered in aggressive retinal astrocytic hamartomas.

Anti-VEGF for Management of Neovascularization of Iris and Neovascular Glaucoma

2018 ◽  
Vol 2 (4) ◽  
pp. 194-199
Author(s):  
Tian Xia ◽  
Marco A. Zarbin ◽  
Neelakshi Bhagat
Keyword(s):  
Retinal Vein Occlusion ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
Complete Regression ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Purpose: To study the treatment effect of antivascular endothelial growth factor (anti-VEGF) injections on eyes with iris neovascularization (NVI). Methods: Retrospective study of patients who underwent intravitreal anti-VEGF for the treatment of NVI at the Rutgers-Institute of Ophthalmology and Visual Sciences between January 1, 2007 and March 30, 2017. Results: Twenty-eight eyes (mean age, 63 ± 13 years old, 12 [43%] males) were identified. All patients had NVI, and 23 patients had concurrent neovascular glaucoma. The etiology of anterior segment ischemia was proliferative diabetic retinopathy in 20 eyes (71%), central retinal vein occlusion in 7 eyes (25%), and branch retinal vein occlusion in 1 eye (4%). Corneal edema in 25 eyes (89%), hyphema in 11 (39%), visually significant cataract in 25 (86%), and vitreous hemorrhage in 15 (54%) precluded an adequate view to the fundus to perform panretinal photocoagulation (PRP). All patients initially received anti-VEGF therapy; PRP was provided in some eyes ( n = 7) with persistent NVI if the view to the fundus improved. On average, 1.66 (median, 1; standard deviation [SD], 1.64) anti-VEGF injections were performed before complete NVI regression was achieved. Complete regression of rubeosis iridis took an average of 42 (median, 40; SD, 48) days from the first injection. Ten eyes (36%) had recurrence of rubeosis at 198 (median, 126; SD, 165) days after complete regression of NVI. Conclusions: NVI regression was noted in all eyes. Anti-VEGF may be a good supplement for initial NVI management in eyes when PRP cannot be initiated.

scholarly journals Coats’ Disease: Very Long-Term Outcome After Early Stage Conventional Treatment

2016 ◽  
Vol 10 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Salvatore Perrone ◽  
Alberto Rossetti ◽  
Patrick Sportiello ◽  
Pierfrancesco Mirabelli ◽  
Pierangela Cimatti ◽  
...  
Keyword(s):  
Conventional Treatment ◽  
Early Stage ◽  
Argon Laser ◽  
Neovascular Glaucoma ◽  
Disease Stage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Advanced Stages ◽  
Coats Disease ◽  
The Mean

Purpose: To report on the outcome of conventional therapy in patients with Coats’ disease. Methods: Retrospective analysis of the charts of thirteen patients with Coats’ disease. Results: Mean age of 9 male (70%) and 4 female (30%) patients was 17.7 (range, 5-33) years; one female had bilateral disease. Eleven eyes with retinal telangiectasia and exudation were treated with argon laser photocoagulation alone or photocoagulation associated with cryotherapy; the mean follow up was 32.5 (range,17-41) years. In four eyes without foveal involvement (stage 2a) the mean presenting visual acuity (VA) remained at 0.8 or improved, whereas poor VA in seven stage 2b eyes deteriorated minimally over time. In one and two of the three eyes with total retinal detachment, phthisis or neovascular glaucoma ensued. Conclusion: About three decades after conventional treatment of Coats’ disease stage 2a, treated eyes maintained good VA, and stage 2b eyes did not progress to advanced stages.

scholarly journals Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Faried Mohammed Wagdy ◽  
Adel Galal Zaky
Keyword(s):  
Previous History ◽  
Visual Outcome ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
History Of ◽  
Therapeutic Tools ◽  
Endothelial Growth Factor ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Purpose. To compare the outcomes of Ex-PRESS glaucoma filtration device and transscleral cyclophotocoagulation (TSCP) in the management of neovascular glaucoma (NVG). Patients and Methods. A total of 30 eyes (12 express shunts and 18 TSCP) of 28 patients were included. The eyes had NVG with intraocular pressure (IOP) more than 21 mmHg of the maximally tolerated medication treatment after previous panretinal photocoagulation and antivascular endothelial growth factor (anti-VEGF) injection, with no previous history of a cyclodestruction procedure or glaucoma surgery, were randomized either for Ex-PRESS glaucoma filtration device or TSCP. The patients were followed up weekly for the first month and then monthly for 12 months as regard to the IOP, number of topical antiglaucoma drugs required, visual outcome, and postoperative complications. Results. IOP was successfully controlled with both techniques in 83.3% of the eyes. Both techniques had fewer complications and required fewer subsequent procedures. Conclusion. Both the Ex-PRESS glaucoma filtration device and TSCP might constitute safe and alternative therapeutic tools for patients with NVG. However, TSCP is an easier procedure, less time consuming, and does not require a learning curve.

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