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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2016

Open Access 01-12-2016 | Research article

Intravitreal ranibizumab injection combined trabeculectomy versus Ahmed valve surgery in the treatment of neovascular glaucoma: assessment of efficacy and complications

Authors: Lan Liu, Yongfeng Xu, Zhu Huang, Xiaoyu Wang

Published in: BMC Ophthalmology | Issue 1/2016

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Abstract

Background

Researches have shown anti-vascular endothelial growth factor (VEGF) agent is effective in treating neovascular eye diseases. The purpose of this study is to evaluate the efficacy and safety of intravitreal ranibizumab (IVR) injection combined trabeculectomy in the treatment of neovascular glaucoma (NVG), and compared it with Ahmed valve surgery.

Methods

Thirty-six NVG patients (37 eyes) from the First Affiliated Hospital of Zhejiang medical college, between January 1, 2014 and January 31, 2015, were included in this prospective, interventional clinical study. Eighteen NVG eyes were given IVR injection one week before trabeculectomy. Ahmed valve implantation surgery was performed in nineteen eyes. Ocular pain, best corrected visual acuity (BCVA), intraocular pressure (IOP) and surgical complications were evaluated before and after the surgery.

Results

IOP was significantly decreased following IVR injection combined trabeculectomy treatment (baseline 57.1 ± 8.9 mmHg; week 1, 15.2 ± 4.3 mmHg p = 0.000; month 1, 16.9 ± 2.1 mmHg p = 0.000; month 3, 20.3 ± 7.7 mmHg p = 0.000; month 6, 19.7 ± 7.3 mmHg p = 0.000). There was a significant, though modest, BCVA improvement in sighted eyes of IVR group (baseline 2.42 ± 0.68, W1 1.80 ± 0.91, P = 0.013; M1 1.77 ± 0.93, p = 0.011). IVR injection combined trabeculectomy had less postoperative complications and lower failure ratio than Ahmed surgery (IVR 5.6 %, Ahmed 31.6 %).

Conclusions

The study revealed that IVR injection combined trabeculectomy was an effective and safe treatment for NVG. Compared with Ahmed surgery, IVR injection combined trabeculectomy had less complications and higher success ratio. (Chinese Clinical Registry, TRN ChiCTR-OPN-16008147, 3/24/2016, retrospectively registered)
Literature
1.
Shazly TA, Latina MA. Neovascular glaucoma: etiology, diagnosis and prognosis. Semin Ophthalmol. 2009;24(2):113–21.CrossRefPubMed
2.
3.
Kuang TM, Liu CJ, Chou CK, Hsu WM. Clinical experience in the management of neovascular glaucoma. J Chin Med Assoc. 2004;67(3):131–5.PubMed
4.
Shweiki D, Itin A, Soffer D, Keshet E. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature. 1992;359(6398):843–5.CrossRefPubMed
5.
Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994;331(22):1480–7.CrossRefPubMed
6.
Tripathi RC, Li J, Tripathi BJ, Chalam KV, Adamis AP. Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma. Ophthalmology. 1998;105(2):232–7.CrossRefPubMed
7.
Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1432–44.CrossRefPubMed
8.
Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–31.CrossRefPubMed
9.
Massin P, Bandello F, Garweg JG, Hansen LL, Harding SP, Larsen M, et al. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes Care. 2010;33(11):2399–405.CrossRefPubMedPubMedCentral
10.
Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology. 2010;117(6):1124–33.CrossRefPubMed
11.
Ehlers JP, Spirn MJ, Lam A, Sivalingam A, Samuel MA, Tasman W. Combination intravitreal bevacizumab/panretinal photocoagulation versus panretinal photocoagulation alone in the treatment of neovascular glaucoma. Retina. 2008;28(5):696–702.CrossRefPubMed
12.
Wakabayashi T, Oshima Y, Sakaguchi H, Ikuno Y, Miki A, Gomi F, et al. Intravitreal bevacizumab to treat iris neovascularization and neovascular glaucoma secondary to ischemic retinal diseases in 41 consecutive cases. Ophthalmology. 2008;115(9):1571–80.CrossRefPubMed
13.
Yazdani S, Hendi K, Pakravan M. Intravitreal bevacizumab (Avastin) injection for neovascular glaucoma. J Glaucoma. 2007;16(5):437–9.CrossRefPubMed
14.
SooHoo JR, Seibold LK, Kahook MY. Recent advances in the management of neovascular glaucoma. Semin Ophthalmol. 2013;28(3):165–72.CrossRefPubMed
15.
Sivak-Callcott JA, O’Day DM, Gass JD, Tsai JC. Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma. Ophthalmology. 2001;108(10):1767–76.CrossRefPubMed
16.
Rulli E, Biagioli E, Riva I, Gambirasio G, De Simone I, Floriani I, et al. Efficacy and safety of trabeculectomy vs nonpenetrating surgical procedures: a systematic review and meta-analysis. JAMA Ophthalmol. 2013;131(12):1573–82.CrossRefPubMed
17.
Chen YH, Lu DW, Cheng JH, Chen JT, Chen CL. Trabeculectomy in patients with primary angle-closure glaucoma. J Glaucoma. 2009;18(9):679–83.CrossRefPubMed
18.
Gariano RF, Gardner TW. Retinal angiogenesis in development and disease. Nature. 2005;438(7070):960–6.CrossRefPubMed
19.
Li Z, Van Bergen T, Van de Veire S, Van de Vel I, Moreau H, Dewerchin M, et al. Inhibition of vascular endothelial growth factor reduces scar formation after glaucoma filtration surgery. Invest Ophthalmol Vis Sci. 2009;50(11):5217–25.CrossRefPubMed
20.
Mathew R, Barton K. Anti--vascular endothelial growth factor therapy in glaucoma filtration surgery. Am J Ophthalmol. 2011;152(1):10–5.CrossRefPubMed
21.
22.
Avery RL. Regression of retinal and iris neovascularization after intravitreal bevacizumab (Avastin) treatment. Retina. 2006;26(3):352–4.CrossRefPubMed
23.
Grover S, Gupta S, Sharma R, Brar VS, Chalam KV. Intracameral bevacizumab effectively reduces aqueous vascular endothelial growth factor concentrations in neovascular glaucoma. Br J Ophthalmol. 2009;93(2):273–4.CrossRefPubMed
24.
Klettner A, Roider J, Klettner A, Roider J. Comparison of bevacizumab, ranibizumab, and pegaptanib in vitro: efficiency and possible additional pathways. Invest Ophthalmol Vis Sci. 2008;49(10):4523–7.CrossRefPubMed
25.
Simha A, Braganza A, Abraham L, Samuel P, Lindsley K. Anti-vascular endothelial growth factor for neovascular glaucoma. Cochrane Database Syst Rev. 2013;10:CD007920.PubMedPubMedCentral
26.
Elmekawey H, Khafagy A. Intracameral ranibizumab and subsequent mitomycin C augmented trabeculectomy in neovascular glaucoma. J Glaucoma. 2014;23(7):437–40.CrossRefPubMed
27.
Kitnarong N, Sriyakul C, Chinwattanakul S. A Prospective Study to Evaluate Intravitreous Ranibizumab as Adjunctive Treatment for Trabeculectomy in Neovascular Glaucoma. Ophthalmol Ther. 2015;4(1):33–41.CrossRefPubMedPubMedCentral
28.
Li XJ, Yang XP, Li QM, Wang YY, Lyu XB. Ranibizumab Plus Combined Surgery for Treatment of Neovascular Glaucoma with Vitreous Hemorrhage. Chin Med J (Engl). 2015;128(15):2078–83.CrossRef
29.
Luke J, Nassar K, Luke M, Grisanti S. Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma--results from a prospective interventional case series. Graefes Arch Clin Exp Ophthalmol. 2013;251(10):2403–13.CrossRefPubMed
30.
Desai RU, Singh K, Lin SC. Intravitreal ranibizumab as an adjunct for Ahmed valve surgery in open-angle glaucoma: a pilot study. Clin Experiment Ophthalmol. 2013;41(2):155–8.CrossRefPubMed
Metadata
Title
Intravitreal ranibizumab injection combined trabeculectomy versus Ahmed valve surgery in the treatment of neovascular glaucoma: assessment of efficacy and complications
Authors
Lan Liu
Yongfeng Xu
Zhu Huang
Xiaoyu Wang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2016
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-016-0248-7

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