A Systematic Review About Bevacizumab For The Treatment Of Neovascular Glaucoma

Objective:To assess the clinical effectiveness of Intravitreal Bevacizumab injectionwith panretinal photocoagulation followed by Ahmed valve implantation in neovascularglaucoma versus panretinal photocoagulation followed by Ahmed valve implantation dueto Neovascular Glaucoma.Methods:we search the Cochrane Central Register ofControlled Trials(issue1,2013),MEDLINE(1966to Jan2013,EMbase(1980to Jan2013).Wealso hand searched relevant journals and coference proceedings.Data were extracted bytwo reviewers independently using an extraction form.The Cochrane Collaboration’sRevMan5.1software was used for statstistical analysis.Results:One RCT involving40participants required treatment were included by total retrieve andriddling.Results:Analysis show that compared with panretinal photocoagulation followedby Ahmed valve implantation group, Intravitreal bevacizumab injection with panretinalphotocoagulation followed by Ahmed valve implantation increased in complete surgicialsuccess rate ［RR=3.00,95%CI （1.35,6.68） P=0.007］,meanIOP decreased ratein1wk,1mo,6mo,18mo［MD=－3.50,95%CI（－5.75,－1.25）P=0.002］，［MD=－6.50,95%CI（－7.93,－5.07）P＜0.00001］，［MD=－12.00,95%CI（－13.62,－10.38）P＜0.00001］，［MD=－12.00,95%CI（－15.39,－8.61）P＜0.00001］ and improvedvisual acuity［RR=4.00,95%CI（1.33,12.05）P=0.01］.Decreased in surgical failure rate［RR=0.10,95%CI（0.01,0.71）P=0.02］,decreased visual acuity ［RR=4.00,95%CI（1.33,12.05）P=0.01］.Conclusion:Compared with panretinal photocoagulation followedby Ahmed valve implantation,the Intravitreal bevacizumab injection with panretinalphotocoagulation followed by Ahmed valve implantation increased in proportion fopatients with complete surgical success rate,meanIOPdecreased rate and visual acuityrate.And decreased the surgical failure rate and visual acuity decreased rate.But accordingto the quality assessment,and the precison,the method of the trial could improve,and there might needed more well-designed large-scale RCTs.