Search

Glaucoma is a group of diseases with progressive optic disk and /or visual fields changes. The mainstays of current therapies (medical, laser, surgery) are focused of lowering intraocular pressure (IOP). The problems and failures with such therapies and the studies on physiopathology and genetics of glaucoma started explorations for new therapeutic modalities. Advances in our understanding of the genetic basis of glaucoma include the discovery of 14 linked sites (GLC 1A through GLC 1N) in primary open-angle glaucoma with three genes identified at these loci: myocilin, optineurin, and WDR 36. In the secondary glaucomas such as pseudoexfoliation syndromes, LOXL1 gene polymorphisms have been identified. Gene therapy can be used to replace a mutated gene that causes disease with a healthy copy of the gene, to inactivate or wipe out the aberrant gene that is responsible for the disease. This therapy can also be used to add or remove genes that are indirectly related to the pathophysiology of the disease. Ocular gene therapy can also provide the advantage of delivery of genes that express therapeutic proteins in a localized and sustained way. Gene therapy studies for the treatment of glaucoma are focused on lowering intraocular pressure and neuroprotection. An ideal gene delivery system is one that is able to efficiently deliver the genes to the target tissue with specificity and safety. Both viral and nonviral vector delivery systems have been tested in the animal eyes. The target tissues of gene therapy are trabecular meshwork, ciliary body, ciliary muscle, retina and optic disk. [ABSTRACT FROM AUTHOR]

Purpose: To determine the long-term efficacy and reliability of intravitreal bevacizumab injection in neovascular glaucoma. Materials and Methods: Eighteen eyes of twelve patients (8 men, 4 women) with diagnosis of neovascular glaucoma were included in this study group. Twelve eyes had proliferative diabetic retinopathy (66.7%) and 6 eyes (33.3%) had central retinal vein occlusion. Intravitreal bevacizumab (1.25 mg/0.05 ml, Altuzan) was injected in all eyes after the completion of laser therapy. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured before and at 1st week, 1st month, 3rd month, and 6th month after the injection; and anterior segment angiography images were obtained before and at the 1st week, 3rd month and 6th month after the injection. Angiographic images were evaluated according to the grading system of iris neovascularization (Stage 0-4). Results: The decrease of symptoms and regression in grade of neovascularization were determined at the first week in all eyes. The mean IOP values were 26.32±1.37 mmHg, 24.14±2.03 mmHg, 26.78±2.19 mmHg, and 27.72±2.28 mmHg at the 1st week, 1st month, 3rd month, and 6th month after injection, respectively (p<0.05). The mean BCVA was 1.14±0.21 LogMAR (0.7-2.0) at the 6th month, and there was no significant difference from preinjection values (p>0.05). Discussion: Intravitreal injection of bevacizumab seems to be effective and safe treatment modality for neovascular glaucoma in long-term period and it can be used as an adjuvant therapy to the panretinal photocoagulation and antiglaucomatous agents. [ABSTRACT FROM AUTHOR]