Neovascular glaucoma anti‐VEGF treatment

Purpose To present the anti-VEGF treatment in neovascular glaucoma following proton beam irradiation in uveal melanomas. Methods Prospective evaluation on 69 cases of iris neovascularisation and neovascular glaucoma treated with anti-VEGF intraocular injections. Results Iris neovascularisation was classified as pupillary 26%, sectorial 16%, tuffts 15% and diffused 43%. A sectorial iris ischemia related to proton beam irradiation was present in 64% of the cases. Following an observation period of 6 months to 3 years a normalisation of the intraocular pressure (less than 20 mm Hg) was obtained in 84% of the cases. Regression of iris tortuosity was observed in 77% of the cases. Regression of the iris neovascularisation in 68 % of the cases and reduction of diffusion of the dye in 67% of the cases. A remodelling of the iris ischemia was observed in 32% of the cases. Conclusion The intraocular injections of anti-VEGF drugs in selected cases is a promising therapeutic approach for the treatment of iris neovascularisation and neovascular glaucoma related to proton beam irradiation of uveal melanomas.