RESUMO
PURPOSE: Systematic review on efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of neovascular glaucoma (NVG). All original papers published in Medline (prior to August 2008) were included. METHODS: Search and selection of information on the internet and in Medline, validated by Kappa Index (K). Statistical and clinical study of the results in the selected articles on a one by one basis. RESULTS: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes). The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. CONCLUSIONS: The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatment for NVG. Clinical trials are needed to confirm these results before its use is authorized.
Assuntos
Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Glaucoma Neovascular/tratamento farmacológico , Corpo Vítreo , Anticorpos Monoclonais Humanizados , Bevacizumab , Humanos , InjeçõesRESUMO
Propósito: Revisión sistemática sobre la eficacia y seguridad de la inyección intravítrea de bevacizumab (IVB) en el tratamiento del glaucoma neovascular(GNV). Se incluyen todos los trabajos originales publicados en Medline hasta agosto de 2008. Métodos: Búsqueda y selección de la información en Internet y Medline, validadas mediante el Índice Kappa (K). Estudio estadístico y clínico de los resultados en los trabajos seleccionados, uno a uno. Resultados: Se encuentran 26 artículos originales que analizan la eficacia y seguridad del procedimiento en casos únicos y en series cortas de casos. 24 de ellos se analizan conjuntamente, con un total de 127 ojos intervenidos. La eficacia calculada para casos difíciles es del 68,7%. Las recidivas en un seguimiento de 4,2 meses son del 18,6%. Todos los trabajos son posteriores a 2006 y ninguno cumple criterios de ensayo clínico aleatorizado. Las complicaciones de la IVB son inferiores al 0,78% y no se observan complicaciones sistémicas. Conclusiones: El bevacizumab demuestra que las inyecciones intravítreas pueden ser muy eficaces y seguras para la manipulación terapéutica de los factores de crecimiento en el segmento anterior. La IVB se perfila como un tratamiento de primera línea en casos de GNV dificiles. Se necesitan ensayos clínicos controlados que confirmen estos resultados y autorizen el uso
Purpose: Systematic review on efficacy and safetyof intravitreal bevacizumab (IVB) in the treatment of neovascular glaucoma (NVG). All original papers published in Medline (prior to August 2008) were included. Methods: Search and selection of information on the internet and in Medline, validated by Kappa Index (K). Statistical and clinical study of the results in the selected articles on a one by one basis. Results: 26 original papers analyzed the efficacy and safety of the procedure in case reports and short series of cases (127 eyes). The efficacy calculated in the sample was 68.7% and the recurrence rate was 18.6% in 4.2 months of follow-up. All studies were after 2006 and none of them was a clinical randomized controlled assay. Ophthalmic complications were under 0.78% and no systemic complications were found. Conclusions: The use of bevacizumab demonstrates that intravitreal injections may be effective and useful to manipulate growth factors in the anterior chamber. IVB could serve as a first line treatmentfor NVG. Clinical trials are needed to confirm these results before its use is authorized
