Abstract
Purpose: :
To evaluate the effect of an injection of bevacizumab to subtenon for ocular surface neovascularization secondary to pterygium, Stevens-Johnson syndrome, herpetic eye disease, or chemical burn by analyzing the changes of growth factors, cytokines, and metalloproteinase(MMP) levels in tear samples.
Methods: :
Tear samples were obtained from 51 eyes of 43 patients who underwent an injection 5mg of bevacizumab to subtenon. The degree of neovascularization was graded for extent and density of neovasuclarized area on the anterior segment photographs. Tear samples were obtained at baseline, 1day, 1week, and 1month after the injection. Tear samples also were obtained in 24 normal eyes for control group. Concentrations of growth factors (VEGF, EGF, bFGF, PDGF-AB), cytokines (IL-1β, TNF-, MCP-1), and MMP-9 in tear smaples were measured using microsphere immunoassays and analyzed.
Results: :
After an injection of bevacizumab to subtenon, the degree of neovascularization reduced and there was no systemic side effect, but focal complication like epithelial erosion was detected. The mean concentrations of VEGF, bFGF, PDGF-AB, IL-1β, TNF-, MCP-1, and MMP-9 were higher than control group, whereas the mean concentration of EGF was lower in the eyes with ocular surface neovascularization. The mean ± standard deviation VEFG level in tear reduced from 107.5±90.6 pg/ml at baseline to 36.6±22.5 pg/ml at 1day, and decreased level of VEGF was maintained through 1month. The change pattern of PDGF-AB level was similar to VEGF, whereas the mean concentrations of IL-1β and MCP-1 increased significantly at 1day and maintained through 1month. The mean concentrations of EGF, bFGF, and MMP-9 increased slightly after bevacizumab injection, but there were no significant changes.
Conclusions: :
An injection of bevacizumab to subtenon resulted in substantial reduced VEGF levels in tear samples of patients with ocular surface neovascularization. This change may be favorable for the inhibition of ocular surface angiogenesis but other changes of growth factors and cytokines may be suggestive of side effects like increased fibrosis and inflammation.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • growth factors/growth factor receptors