Abstract
Purpose: :
To study the safety and efficacy of topical bevacizumab in the treatment of corneal NV.
Methods: :
Twenty eyes of 20 patients with stable corneal NV were treated in a prospective, open-label, noncomparative study, with 1% topical bevacizumab for 3 weeks, and followed up for 24 weeks. The main efficacy outcomes measured were neovascular area (NA), the area of the corneal vessels themselves; vessel caliber (VC), the mean diameter of the corneal vessels; and invasion area (IA), the fraction of vessel incursion in the cornea. The occurrences of ocular and systemic adverse events through the study were recorded as the safety variables.
Results: :
Compared to the baseline visit, the NA showed statistically significant improvement at week 6 (mean= 27.9%, P=0.007), which was 3 weeks after stopping the medication, and the VC at week 12 (mean= 30.8%, P=0.006), which was 9 weeks after the treatment of study drug. By week 24, the mean reductions were 47.5% (standard deviation [SD], 37.5%) for NA, 36.2% (SD, 44.1%) for VC, and 20.0% (SD, 42.0%) for IA. The decreases in NA and VC were statistically significant (P< 0.001 and P= 0.003, respectively), but IA was not (P= 0.06). No significant change was noted in visual acuity or central corneal thickness. Topical bevacizumab was well tolerated with no adverse events.
Conclusions: :
Short-term topical bevacizumab therapy effectively reduces the severity of corneal NV without local or systemic adverse effects. Interestingly, statistically significant reductions in NV parameters are evident well after termination of therapy. Although the efficacy is delayed, it remains stable at least beyond early time points.
Clinical Trial: :
http://www.clinicaltrials.gov NCT 00512876
Keywords: cornea: clinical science • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • imaging/image analysis: clinical