Abstract

P 233

Simultaneous intracameral und intravitreal injection of bevacizumab in neovascular glaucoma after central retinal vein occlusion

Meyer M. W., Meyer A., Brunotte I., Winter R.
Department of Ophthalmology, Hanover Medical School

Objective: Case report of a 68-year-old patient with neovascular glaucoma after central retinal vein occlusion months ago in the left eye. To determine simultaneous intracameral und intravitreal injection of bevacizumab, an antibody against vascular endothelial growth factor (VEGF).
Methods: In history the patient received cyclodestructive photocoagulation twice without any success. Ophthalmologic examination revealed iris rubeosis, neovascular glaucoma with an intraocular pressure (IOP) of 44 mmHg, corneal edema, macular edema and marked reduced visual acuity. The patient suffered from pain. The patient received a simultaneous intracameral and intravitreal injection of 1,0 mg respectively 1,25 mg bevacizumab.
Results: A few days after intracameral and intravitreal injection of bevacizumab the pain in the left eye resolved and examination demonstrated partial regression of the iris and angle neovascularization. Five days after injection the IOP was 16 mmHg and corneal edema was regressive. Two weeks after injection panretinal photocoagulation was performed. Four and 12 weeks post-treatment these findings have been stable, neovascularization was completely resolved and no further injection of bevacizumab was necessary.
Conclusions: No previous reports exist regarding simultaneous intracameral und intravitreal injection of bevacizumab to treat neovascular glaucoma after central retinal vein occlusion. The current case demonstrates that simultaneous blocking of VEGF in the anterior and posterior segment of the eye may be associated with rapid stabilization of findings and complete regression of iris and angle neovascularization.

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