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著者: Taku Wakabayashi, Yusuke Oshima, Hirokazu Sakaguchi, Yasushi Ikuno, Atsuya Miki, Fumi Gomi, Yasumasa Otori, Motohiro Kamei, Shunji Kusaka, Yasuo Tano
雑誌名: Ophthalmology. 2008 Sep;115(9):1571-80, 1580.e1-3. doi: 10.1016/j.ophtha.2008.02.026. Epub 2008 Apr 28.
Abstract/Text
PURPOSE: To evaluate the biologic efficacy of intravitreal bevacizumab (IVB) for iris neovascularization (INV) or neovascular glaucoma (NVG) in patients with ischemic retinal disorders.
DESIGN: Retrospective, consecutive, interventional case series.
PARTICIPANTS: Thirty patients (41 eyes) with INV or NVG secondary to ischemic retinal disorders.
METHODS: Patients received IVB (1 mg) as the initial treatment for INV or NVG and were followed up for at least 6 months. Ophthalmic evaluations included measurement of visual acuity and intraocular pressure (IOP), a complete ophthalmic examination, and fluorescein angiography. Patients were divided into 3 subgroups: INV without elevated IOP (INV group), NVG with an open angle (O-NVG group), and NVG with angle closure (C-NVG group) for outcomes analysis.
MAIN OUTCOME MEASURES: The controllability of IOP by IVB, incidence of recurrence, and requirement for surgery to treat NVG.
RESULTS: No significant ocular or systemic adverse events developed during follow-up (range, 6-22 months; mean, 13.3 months). The mean IOP levels were 14.7, 31.2, and 44.9 mmHg at baseline in the INV, O-NVG, and C-NVG groups, respectively. In the INV group (9 eyes), the INV regressed or resolved after 1 injection. Iris neovascularization recurred in 4 eyes by 6 months and stabilized after repeated injections without IOP elevation. In the O-NVG group (17 eyes), rapid neovascular regression with successful IOP normalization (CONCLUSIONS: Intravitreal bevacizumab is well tolerated, effectively stabilized INV activity, and controlled IOP in patients with INV alone and early-stage NVG without angle closure. In advanced NVG, IVB cannot control IOP but may be used adjunctively to improve subsequent surgical results. Further evaluation in controlled randomized studies is warranted.
PMID 18440643 Ophthalmology. 2008 Sep;115(9):1571-80, 1580.e1-3. doi: 10.1016/j.ophtha.2008.02.026. Epub 2008 Apr 28.
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