Vitrectomy 23 G with Vascular Endothelial Growth Factor Injection in a Patient with Neovascular Glaucoma with Total Retinal Detachment, Hemorrhage into Anterior Chamber and Vitreous Chamber of the Right Eye – Case Report
Wydanie 2/2023
str. 27 – 29
Autorzy: Sebastian Sirek1,2, Dawid Woszczek3, Rafał Leszczyński2, Ewa Mukwa-Kominek1,2
1. Klinika Okulistyki Katedry Okulistyki Wydziału Nauk Medycznych w Katowicach Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek
2. Oddział Okulistyki Dorosłych Uniwersyteckiego Centrum Klinicznego im. prof. K. Gibińskiego Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek
3 Studenckie Koło Naukowe Kliniki Okulistyki Katedry Okulistyki Wydziału Nauk Medycznych w Katowicach Śląskiego Uniwersytetu Medycznego w Katowicach
Summary:
Introduction: Neovascular glaucoma is a serious eye disease characterized by neovascularization of the iris and anterior chamber angle. The most important risk factors for the development of neovascular glaucoma include retinal ischemia including that caused by proliferative diabetic retinopathy, central retinal vein occlusion, or retinal detachment.
Material and methods: A 61-year-old man with anterior chamber and vitreous chamber hemorrhage, recurrent total retinal detachment and advanced neovascular glaucoma in the right eye.
Results: Visual acuity recorded as hand motion, intraocular pressure measured by applanation tonometry 16 mmHg. The anterior segment showed massive anterior chamber hemorrhage and iris neovascularization. Ultrasound examination of the right eyeball in the B projection showed multiple diffuse extra echoes consistent with hemorrhage into the vitreous chamber and flat total retinal detachment. The patient was scheduled for anterior chamber washout, 23 G posterior vitrectomy with retinal endolaser, silicone oil endotamponade and injection of ranibizumab into the vitreous chamber of the right eye. During the first follow-up, an improvement in visual acuity to a level of 1/50 using Snellen arrays, stabilization of intraocular pressure to a level of 11 mmHg, and retinal adhesion was achieved. Conclusions: pars plana vitrectomy in patients with anterior chamber and vitreous chamber hemorrhage, retinal detachment and neovascular glaucoma is an effective surgical procedure for restoring useful visual acuity. In addition, ranibizumab injection has a direct effect on reducing the level of intraocular vascular endothelial growth factor and causes regression of neovascularization in the retina, angle and iris.