[Results of trabeculectomy with anti-VGEF therapy in the treatment of neovascular glaucoma secondary to retinal vein occlusion (report of 21 cases followed at Bukavu Eye Clinic from January 1 to December 31th, 2015)]. / Résultats de la trabéculectomie associée aux anti-VGEF dans le traitement du glaucome néovasculaire compliquant les occlusions veineuses rétiniennes (à propos de 21 cas, suivis à la clinique ophtalmologique de Bukavu du 1er janvier au 31 décembre 2015).

PURPOSE: To evaluate the results of anti-VGEF with trabeculectomy in the treatment of neovascular glaucoma, a severe complication of retinal vein occlusion (RVO). PATIENTS AND METHODS: This is a prospective case series of consecutive patients with neovascular glaucoma secondary to retinal vein occlusion. All patients underwent panretinal photocoagulation and a mean of 3 anti-VEGF injections prior to trabeculectomy. Ophthalmic parameters were recorded pre- and postoperatively: visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography. Minimum follow-up was 9 months. RESULTS: Twenty-one eyes of 21 patients were included. The mean preoperative intraocular pressure was 38mmHg (31-45mmHg). Postoperatively, the mean IOP was 15mmHg (13-19mmHg). IOP reduction was observed in all eyes after surgery and stayed finally stabilized in nineteen eyes (90.5 %). The rubeosis had definitively disappeared an average of two weeks after injection, but VA decreased in all patients. Nineteen patients (90.5 %) maintained preservation of their eyes. Two eyes underwent evisceration. CONCLUSION: In most cases, trabeculectomy with anti-VGEF halted anterior segment neovascularization. It allowed for surgery on a quiet, normotensive eye, with good postoperative results. While functional rehabilitation was not achieved, the globe was able to be preserved in 90.5 % of cases.

[Anti-VEGF therapy in the treatment of anterior segment neovascularization secondary to central retinal vein occlusion]. / Apport des anti-VEGF dans le traitement de la néovascularisation du segment antérieur compliquant les occlusions veineuses rétiniennes.

PURPOSE: To evaluate the benefit of anti-VEGF in the treatment of anterior segment neovascularization (ASNV), a severe complication of ischemic central retinal vein occlusion (CRVO). PATIENTS AND METHODS: This is a retrospective case series of consecutive patients with ASNV secondary to CRVO treated with anti-VEGF. Ophthalmic parameters were recorded for each visit: measurement of best visual acuity (VA), intraocular pressure (IOP), iris examination, gonioscopy and fundus examination, and as necessary, fluorescein angiography and optical coherence tomography. Minimum follow-up was 6 months. RESULTS: Nineteen patients (19 eyes) received intravitreal injections of anti-VEGF in association with panretinal photocoagulation (PRP). In patients who had uncomplicated rubeosis iridis without elevated IOP (n=6), after a mean of 3 injections, VA was stable in 4 patients and improved by two lines in 2 patients. In patients with early neovascular glaucoma (NVG) (n=13), IOP reduction was observed in all eyes within 1 week after injection but increased secondarily after an average of 45 days, although the rubeosis had definitively disappeared, which suggested that the change in IOP was independent of ASNV. After a mean of 6 injections in combination with filtering or cyclodestructive surgery, IOP finally stabilized, but VA decreased in all patients. Three patients (50%) with stage III ASNV progressed to stage IV ASNV in spite of anti-VEGF treatment. CONCLUSION: In all eyes, anti-VEGF treatment stopped neovascularization and helped to control IOP. However, vision was preserved only in the eyes with uncomplicated rubeosis at the time of diagnosis. Since only 32% of eyes were diagnosed at this stage, the authors suggest the prevention of ASNV by careful screening and follow-up of patients at risk, and the performance of PRP in CRVO with extensive retinal non-perfusion prior to the onset of rubeosis.