Effect of Simultaneous Intravitreal Bevacizumab and Retrobulbar Triamcinolone Injection in Refractory Neovascular Glaucoma

ABSTRACT

PURPOSE: To identify the regression of neovascularization and relief of other symptoms after intravitreal bevacizumab and retrobulbar triamcinolone injection in neovascular glaucoma patients with no possibility of visual acuity recovery. METHODS: A total of 15 eyes in 15 patients with neovascular glaucoma, who had no possibility of visual acuity recovery and could not be treated with surgical intervention despite pain from October 2008 to May 2009, were reviewed retrospectively. Changes in degree of pain, conjunctival injection, revascularization, and visual acuity were evaluated after injection. RESULTS: Ten of the 15 (67%) neovascular glaucoma patients were male, with a mean age of 62.50+/-12.79 years. The most common prediposing ocular disease was diabetic retinopathy (9; 60%), and the others were central retinal vein occlusion (4 26%), central retinal artery occlusion (1; 7%), and uveitis (1; 7%). Change in intraocular pressure was significant (p<0.001), as were decreases in the degrees of pain and conjunctival injection (p<0.001, <0.001) after the injections. Regression of neovascularization continued in 13 patients (87%) after two months. CONCLUSIONS: Intravitreal bevacizumab and retrobulbar triamcinolone injection is a safe intervention that can substantially relieve pain experienced by neovascular glaucoma patients.