Efficacy of Intravitreal Ranibizumab Combined With Ahmed Glaucoma Valve Implantation for the Treatment of Neovascular Glaucoma

Min Tang; Yang Fu; Ying Wang; Zhi Zheng; Ying Fan; Xiaodong Sun; Xun Xu


BMC Ophthalmol. 2016;16(7) 

In This Article


Neovascular glaucoma (NVG) is a medical condition in which neovascularization involving the iris and the anterior chamber angle is accompanied by the formation of a fibrovascular membrane that results in secondary angle closure and obstructs the aqueous outflow. The main causes include diabetic retinopathy (DR), retinal vein occlusion (RVO), retinal artery occlusion (RAO) and ocular ischemic syndrome.[1] Ahmed glaucoma valve (AGV) implantation is an effective treatment for NVG, but the procedure is associated with poor outcomes.[2] A study found that vascular endothelial growth factor (VEGF) is a key factor causing NVG, as demonstrated by significantly higher VEGF levels in the aqueous humor of NVG patients.[3] VEGF levels in the aqueous humor are known to play a significant role in determining the outcomes of NVG patients after AGV implantation.[4]

Because of their role in inhibiting intraocular neovascularization and mitigating damage to the blood ocular barrier due to leakage from new vessels, anti-VEGF factors have been used alone or in combination for the treatment of NVG. However, currently available evidence remains insufficient to confirm the effectiveness of such drugs. Ranibizumab (Lucentis) is now used in the treatment of age-related macular degeneration and macular edema as an anti-VEGF factor,[5,6] but it remains unclear whether ranibizumab will affect the efficacy of AGV implantation for NVG patients.

This prospective study was designed to compare the difference in efficacy at a follow-up of six to 12 months in NVG patients with or without a single intravitreal injection of ranibizumab (IVR) before AGV implantation.