Intravitreal bevacizumab (Avastin) injection for neovascular glaucoma

Purpose: To report two cases with neovascular glaucoma secondary to ischemic central retinal vein occlusion (CRVO) who were treated with intravitreal bevacizumab. Case Report: Two patients were referred for neovascular glaucoma following CRVO. Visual acuity was light perception. Both eyes had extensive iris neovascularization (NVI), synechial angle closure and high intraocular pressure (IOP) in spite of antiglaucoma medications. After obtaining informed consent, both eye received an intravitreal injection of 2.5 mg (0.1 ml) bevacizumab (Avastin). Both eyes demonstrated dramatic IOP reduction together with decreased severity and extent of NVI during 4 weeks of follow up. Visual acuity remained unchanged. Conclusion: Despite the dramatic short-term response in terms of IOP reduction and regression of neovascularization, due to limited clinical experience, one should consider this novel indication for bevacizumab cautiously.