Use of Intravitreal Bevacizumab for the Treatment of Secondary Glaucoma Caused by Metastatic Iris Tumor.

Abstract:

PURPOSE:The purpose of this article was to report the efficacy of intravitreal bevacizumab to resolve secondary angle-closure glaucoma caused by biliary tract carcinoma metastasis to the iris. MATERIALS AND METHODS:A 52-year-old white woman who was under systemic chemotherapy for biliary tract carcinoma presented with a metastatic tumor in the left iris. At presentation, her visual acuity was at the 20/50 level. The tumor was occupying the nasal half of the iris, and had already occupied 5.5 clock hours of the angle, resulting in intraocular pressure elevation to 34 mm Hg. Several small clumps of tumor seeds were also observed on the iris and along the angle. Her intraocular pressure remained high despite full medical therapy with dorzolamide, timolol, brimonidine, and oral acetozolamide. Because of the vascularized nature of the tumor, antivascular endothelial growth factor (anti-VEGF) treatment with 3 repeated injections of bevacizumab (1.25 mg/0.05 mL) was applied 1-month apart. Bevacizumab treatment resulted in an abrupt decrease in tumor mass and disappearance of tumoral seeds from the anterior chamber. The patient's vision improved to 20/20, and intraocular pressure decreased to normal levels. CONCLUSIONS:Anti-VEGF treatment with intravitreal bevacizumab can restore sight and achieve intraocular pressure control in metastatic iris tumors complicated with secondary glaucoma. Anti-VEGF drugs are viable alternatives for the treatment of secondary angle-closure glaucoma induced by metastatic iris tumors and can prevent enucleation of these eyes.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Aydin R,Tezel TH

doi

10.1097/IJG.0000000000000959

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

e113-e116

issue

6

eissn

1057-0829

issn

1536-481X

journal_volume

27

pub_type

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