Purpose:
To investigate the efficacy of topically applied Bevacizumab(Avastin) for corneal neovascularization (NV) and neovascularglaucoma (NVG).
Methods:
Patients with corneal NV or NVG were treated with topical Bevacizumab(25mg\ml) four times a day for two weeks period. Anterior segment(corneal or iris) color photos were taken at days 0 and 14.During follow up the following parameters were evaluated (days0,3,7,14): visual acuity, intraocular pressure (IOP), anteriorsegment, lens, fundus, heart rate and blood pressure.
Results:
Four patients with corneal NV responded to treatment accordingly:pseudophakic bullous keratopathy - moderate NV regression (figure1); pterygium - mild NV regression; Herpes simplex virus keratitiswith corneal scarring - very mild NV regression; pannus secondaryto blepharitis - no NV regression. Two patients with neovascularglaucoma secondary to ocular ischemic syndrome (figure 2) andcentral retinal vein occlusion reduced their IOPs in 43% (28mmHgto 16mmHg) and 29% (38mmHg to 27mmHg) respectively, with mildrubeosis iridis regression. The only adverse event observedwas temporary headache in one patient that spontaneously resolvedwithin 1 day.
Conclusions:
Short term topical administration of Bevacizumab may resultin regression of corneal NV in selected patients, and reduceIOP in NVG. Further long term studies are needed to fully evaluatethe efficacy and adverse events of this treatment.
Clinical Trial:
Tel Aviv Sourasky Medicl Center IRB
Keywords: cornea: clinical science • anterior segment • neovascularization