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Intravitreal Bevacizumab (Avastin) in the Treatment of Neovascular Glaucoma-Four Case Reports
眼內注射bevacizumab在增生血管性青光眼的治療
摘要
目的：報告四例增生血管性青光眼用眼內注射bevacizumab的輔助治療效果。 方法：病例報告。 結果：四位病患皆因增生性糖尿病視網膜病變，造成次發性增生血管性青光眼，並皆接受過視網膜全層雷射治療。當中六隻眼睛皆接受眼內注射1.25mg/0.05ml bevacizumab的治療。注射後第一天虹膜新生血管急速的消失並伴隨眼壓的下降。對於未有廣泛虹彩隅角沾黏的病例，合併青光眼藥物的治療眼壓可控制到正常範圍，但對於隅角閉鎖性併嚴重虹彩隅角沾黏的病例，則需要用手術治療控制眼壓。虹膜新生血管的消失，可減少手術中出血併發症，手術時間及恢復期，特別對於併嚴重虹膜新生血管的病例。 結論：眼內注射bevacizumab對於增生血管性青光眼之虹膜及隅角新生血管增生是一個安全又有效的輔助治療，但對於術後隅角虹膜的新生血管增生及眼壓仍需密切追蹤。
關鍵字
無資料並列摘要
Purpose: To report on six eyes in four cases of neovascular glaucoma (NVG) treated adjunctively with intravitreal bevacizumab injection (IVB). Method: Case report. Results: Four patients with proliferative diabetic retinopathy who were treated with panretinal photocoagulation (PRP) had secondary NVG. Six eyes in four patients received an intravitreous injection of bevacizumab (1.25 mg/0.05 ml). Neovascularization of the iris regressed rapidly with a decrease in intraocular pressure (IOP) on the first day after IVB. In eyes without extensive synechial angle closure after IVB, IOP was controlled in normal range with antiglaucoma medications. In cases with extensive peripheral anterior synechiae, filtering surgery with antimetabolite was also performed to control IOP. Regression of neovascularization in both the iris and the angle after IVB resulted in patients having less operative procedure time, decreased risk of intra-operative hemorrhage, and quicker recovery, especially for those with extensive neovascularization of the iris. Conclusion: IVB is a safe and effective adjunctive treatment for anterior segment neovascularization in NVG. Close follow-up of rubeosis iridis and IOP after IVB is necessary. Filtering surgery may be indicated in eyes with extensive peripheral anterior synechiae.
延伸閱讀
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