Researchers from Rutgers University suggest that anti-vascular endothelial growth factor (anti-VEGF) injections may be good option for initial iris neovascularization (NVI) management when panretinal photocoagulation (PRP) cannot be initiated.

This retrospective study evaluated 28 eyes—all patients had NVI, and 23 had concurrent neovascular glaucoma. Study participants received anti-VEGF therapy, and PRP was performed on seven eyes with persistent NVI and viewable fundi.

The team found that the etiology of anterior segment ischemia was proliferative diabetic retinopathy in 20 eyes, central retinal vein occlusion in seven and branch retinal vein occlusion in one. They note that corneal edema in 25 eyes, hyphema in 11, visually significant cataract in 25 and vitreous hemorrhage in 15 precluded an adequate view to the fundus to perform PRP.

They found that an average of 1.66 anti-VEGF injections were performed before complete NVI regression was achieved. They add that complete regression of rubeosis iridis took an average of 42 days from the first injection, and 10 eyes had recurrence of rubeosis 198 days after complete NVI regression took place.

Xia T, Zarbin MA, Bhagat N, et al. Anti-VEGF for management of neovascularization of iris and neovascular glaucoma. J Vitreoretin Dis. 2018;2(4):194-9.