Abstract
Purpose: To compare the effect of intracameral Bevacizumab with sub-conjunctival Bevacizumab in the treatment of neovascular glaucoma. Study Design:  Quasi Experimental study. Place and Duration of Study:  This study was conducted at Civil hospital Karachi, Pakistan from September 2017 to October 2018. Material and Methods:  Patients with intractable Neo-vascular glaucoma visiting the outpatient department of civil hospital, Karachi were included in the study and followed up for 8 months. Patients with sulcus or scleral fixation IOLs and those who were treated with vitreoretinal surgeries were excluded. Patients were divided into two groups. Group A included patients treated with intracameral Bevacizumab and in group B, patients treated with sub-conjunctival Bevacizumab were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and neovascularization of the iris (NVI) were compared between the two groups. Results:  Thirty-eight eyes were included in the study; 24 (56.7%) right eyes and 14 (43.3%) left eyes. Most of the patients were males with mean age of 54.53 ± 7.2 years. Mean total injection/eye was 3.45 ± 1.73 in group A and 3.12 ± 2.10 in group B. Pre-injection BCVA (log MAR) was 0.48 ± 0.32 in group A and 0.34 ± 0.32 in group B. At 8 months, BCVA was 1.7 ± 0.2 in group A and 0.48 ± 0.34 in group B which were statistically significant. Pre-injection IOP (mmHg) was 48.9 ± 1.8 in group A and 47.34 ± 1.8 in group B. Post-injection IOP was 28.7±0.8 in group A (p = 0.001) and 34.2 ± 3.4 in group B (p = 0.11) at eight months. Conclusion:  This study demonstrates that intracameral Bevacizumab significantly improves BCVA and controls IOP in neovascular glaucoma. However, sub-conjunctival Bevacizumab significantly improves BCVA but decrease in IOP is not statistically significant.

Sharjeel Sultan, Nisar Siyal, Nazish Waris, Rasheed Khokhar. (2020) Intracameral Bevacizumab versus Subconjunctival Bevacizumab in the Treatment of Neovascular Glaucoma, Pakistan Journal of Ophthalmology, Volume 36, Issue 1.
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