Intravitreal ranibizumab for neovascular glaucoma: an interventional case series

Abstract

Objective: To evaluate the efficacy of ranibizumab in treating neovascular glaucoma. Design: Prospective interventional case series. Participants: Six eyes of 6 patients. Method: Six eyes with refractory neovascular glaucoma were treated with one dose of 0.5 mg intravitreal ranibizumab followed by laser panretinal photocoagulation. Patients were divided into 2 groups based on angle status for comparison. Recurrence was defined as re-emergence of iris neovascularization, and an intraocular pressure of more than 21 mm Hg after stabilization. Results: The patients’ mean age was 59 years and the mean follow-up 23 weeks. Three eyes had open-angle glaucoma, and three had a closed-angle configuration glaucoma. In 5 (83%) of the eyes, neovascularization completely regressed within the first 48 hours of intravitreal ranibizumab injection. Overall mean intraocular pressure dropped from 27.0 mm Hg pretreatment to 18.3 mm Hg 1 week post–intravitreal ranibizumab. The mean anti-glaucoma drop usage decreased from 4.2 pre-treatment to 2.2 one month later. There was no recurrence throughout the initial 3 months, but 2 eyes with closed-angle configuration glaucoma recurred, with a mean time to recurrence of 14 weeks. Conclusions: These results suggested that intravitreal ranibizumab is a useful and safe adjunct in the management of neovascular glaucoma.