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• W2068638936 abstract "A 48-year-old woman presented with asymmetric vision loss: the right eye being more aff ected than the left eye. She had a history of uncontrolled type 2 diabetes, 100% occlusion of the right carotid artery, and transient ischaemic attacks. She also had a history of proliferative diabetic retinopathy in both eyes, and had undergone multiple retinal surgeries for repair of retinopathy-related traction retinal detach ments in her right eye. Diabetic macular oedema was present in the left eye. Examination of the right eye showed traction of the pupillary edge by a fi brovascular membrane (fi gure A, arrow). Cataracts were present in both eyes: however, the cataract in the left eye was milder than the cataract in the right eye. Pathological iris neovascularisation extended onto the cataractous lens (fi gure A, B, arrowheads). Vascular leakage was confi rmed by iris angiography (blurred hyperfl uorescence; fi gure C, arrowhead). Ultrasonography did not show a tumour or retinal detachment. We diagnosed ocular ischaemic syndrome secondary to right carotid artery occlusion, related to systemic type 2 diabetes. Insuffi cient view was available for pan-retinal photocoagulation—the standard treatment for iris neovascularisation—because of the cataract. The patient received a subconjunctival injection of bevacizumab 2·5 mg (Genentech, South San Francisco, CA, USA), an antibody against vascular endothelial growth factor (VEGF; fi gure D, asterisk). 5 weeks later, regression of iris neo vascularisation was observed (fi gure E–G, arrowheads). The patient was referred to a primary-care physician to assist with control of diabetes and systemic anticoagulation. The anti-angiogenic eff ect was temporary, and the patient received three injections in the following 6 months to maintain regression and normal intraocular pressure. The patient continues to receive treatment. To date, no corneal epitheliopathy, conjunctival injection, or other toxic eff ects have been reported. Pathological iris neovascularisation occurs in 9–24% of patients with proliferative diabetic retinopathy, and can contribute to glaucoma, pain, and blindness, with surgical removal of the eye an outcome in some aff ected patients. Pathological iris neovascularisation occurs in two-thirds of cases of ocular ischaemic syndrome. This syndrome is often related to carotid disease secondary to diabetes mellitus, and is a serious disorder associated with a 5 year mortality of 40%, usually secondary to a cardiovascular cause." @default.
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• W2068638936 date "2014-02-01" @default.
• W2068638936 modified "2023-09-23" @default.
• W2068638936 title "Regression of iris neovascularisation secondary to diabetic retinopathy with subconjunctival anti-VEGF therapy" @default.
• W2068638936 doi "https://doi.org/10.1016/s2213-8587(13)70150-5" @default.
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