Acta Ophthalmologica 2014
Letter to the Editor Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up Minwen Zhou,1,2 Jiawei Wang3 and Xiaodong Sun1,2 1
Department of Ophthalmology, Shanghai First People’s Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; 2Shanghai Key Laboratory of Fundus Disease, Shanghai, China; 3State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China doi: 10.1111/aos.12608
Editor, read with interest the article by Arcieri and colleagues (Arcieri et al. 2014) on clinical outcomes of Ahmed glaucoma valve (AGV) implantation with intravitreal bevacizumab (IVB) treatment for neovascular glaucoma (NVG). The authors aimed to evaluate the efficacy and safety of this combined treatment for NVG. They concluded that IVB may lead to regression of new vessels in patients with NVG undergoing AGV implantation. They also contended there is a trend to slightly lower intraocular pressures
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(IOPs) with IVB use during AGV implantation for NVG. We congratulate and applaud their interesting and important work on this topic; however, we have one query to communicate with the authors about the timing of IVB injection. In this study, the authors performed the IVB injection at the end of AGV implantation surgery. Concerning the combined therapy (IVB injection plus AGV implantation) for NVG, several papers have been published (Mahdy et al. 2013; Sevim et al. 2013; Zhou et al. 2013; Kang et al. 2014). However, of these studies, various researchers carried out the IVB injection at different times. In Mahdy’s study (Mahdy et al. 2013), they performed AGV implantation 2 weeks after a single IVB injection. In Kang’s study (Kang et al. 2014), AGV implantation was performed between 1 and 20 days after IVB. In another study (Sevim et al. 2013), AGV implantation was carried out 7–14 days after IVB. Among these studies, we found that there is absent a uniform interval between IVB and AGV implantation. I wonder why the authors chose the IVB injection at the same time as the AGV implantation. Despite some patients undergoing panretinal photocoagulation (PRP) treatment, the iris neovascularization (NVI) of the patients might still exist. Our previous study had found that the NVI of most of the eyes completely regressed within 2–8 days after IVB (Zhou et al. 2013). If the authors performed IVB treatment before AGV, the NVI would regress, and it might decrease the incidence of hyphema complications. Moreover, we also inquire whether the authors had ever considered that this interval might affect the efficacy of AGV implantation.
References Arcieri ES, Paula JS, Jorge R, Barella KA, Arcieri RS, Secches DJ & Costa VP (2014): Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up. Acta Ophthalmol 1249: 3. Kang JY, Nam KY, Lee SJ & Lee SU (2014): The effect of intravitreal bevacizumab injection before Ahmed valve implantation in patients with neovascular glaucoma. Int Ophthalmol 34: 793–799. Mahdy RA, Nada WM, Fawzy KM, Alnashar HY & Almosalamy SM (2013): Efficacy of intravitreal bevacizumab with panretinal photocoagulation followed by Ahmed valve implantation in neovascular glaucoma. J Glaucoma 22: 768–772. Sevim MS, Buttanri IB, Kugu S, Serin D & Sevim S (2013): Effect of intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in neovascular glaucoma. Ophthalmologica 229: 94–100. Zhou MW, Wang W, Huang WB, Chen SD, Li XY, Gao XB & Zhang XL (2013): Adjunctive with versus without intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma. Chin Med J (Engl) 126: 1412–1417.
Correspondence: Xiaodong Sun Department of Ophthalmology Shanghai First People’s Hospital School of Medicine Shanghai JiaoTong University 100 Haining Road, Shanghai 200080 China Tel: +86 21 63067385 Fax: +86 21 63067385 Email: [email protected]
None of the authors has financial or other conflict of interests concerning this study.
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Letter to the Editor Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up Minwen Zhou,1,2 Jiawei Wang3 and Xiaodong Sun1,2 1
Department of Ophthalmology, Shanghai First People’s Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China; 2Shanghai Key Laboratory of Fundus Disease, Shanghai, China; 3State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China doi: 10.1111/aos.12608
Editor, read with interest the article by Arcieri and colleagues (Arcieri et al. 2014) on clinical outcomes of Ahmed glaucoma valve (AGV) implantation with intravitreal bevacizumab (IVB) treatment for neovascular glaucoma (NVG). The authors aimed to evaluate the efficacy and safety of this combined treatment for NVG. They concluded that IVB may lead to regression of new vessels in patients with NVG undergoing AGV implantation. They also contended there is a trend to slightly lower intraocular pressures
I
(IOPs) with IVB use during AGV implantation for NVG. We congratulate and applaud their interesting and important work on this topic; however, we have one query to communicate with the authors about the timing of IVB injection. In this study, the authors performed the IVB injection at the end of AGV implantation surgery. Concerning the combined therapy (IVB injection plus AGV implantation) for NVG, several papers have been published (Mahdy et al. 2013; Sevim et al. 2013; Zhou et al. 2013; Kang et al. 2014). However, of these studies, various researchers carried out the IVB injection at different times. In Mahdy’s study (Mahdy et al. 2013), they performed AGV implantation 2 weeks after a single IVB injection. In Kang’s study (Kang et al. 2014), AGV implantation was performed between 1 and 20 days after IVB. In another study (Sevim et al. 2013), AGV implantation was carried out 7–14 days after IVB. Among these studies, we found that there is absent a uniform interval between IVB and AGV implantation. I wonder why the authors chose the IVB injection at the same time as the AGV implantation. Despite some patients undergoing panretinal photocoagulation (PRP) treatment, the iris neovascularization (NVI) of the patients might still exist. Our previous study had found that the NVI of most of the eyes completely regressed within 2–8 days after IVB (Zhou et al. 2013). If the authors performed IVB treatment before AGV, the NVI would regress, and it might decrease the incidence of hyphema complications. Moreover, we also inquire whether the authors had ever considered that this interval might affect the efficacy of AGV implantation.
References Arcieri ES, Paula JS, Jorge R, Barella KA, Arcieri RS, Secches DJ & Costa VP (2014): Efficacy and safety of intravitreal bevacizumab in eyes with neovascular glaucoma undergoing ahmed glaucoma valve implantation: 2-year follow-up. Acta Ophthalmol 1249: 3. Kang JY, Nam KY, Lee SJ & Lee SU (2014): The effect of intravitreal bevacizumab injection before Ahmed valve implantation in patients with neovascular glaucoma. Int Ophthalmol 34: 793–799. Mahdy RA, Nada WM, Fawzy KM, Alnashar HY & Almosalamy SM (2013): Efficacy of intravitreal bevacizumab with panretinal photocoagulation followed by Ahmed valve implantation in neovascular glaucoma. J Glaucoma 22: 768–772. Sevim MS, Buttanri IB, Kugu S, Serin D & Sevim S (2013): Effect of intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in neovascular glaucoma. Ophthalmologica 229: 94–100. Zhou MW, Wang W, Huang WB, Chen SD, Li XY, Gao XB & Zhang XL (2013): Adjunctive with versus without intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma. Chin Med J (Engl) 126: 1412–1417.
Correspondence: Xiaodong Sun Department of Ophthalmology Shanghai First People’s Hospital School of Medicine Shanghai JiaoTong University 100 Haining Road, Shanghai 200080 China Tel: +86 21 63067385 Fax: +86 21 63067385 Email: [email protected]
None of the authors has financial or other conflict of interests concerning this study.
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