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Y. Koenig, F. Bock, F. E. Kruse, C. Cursiefen; Short- and Long-Term Safety of Topical Bevacizumab (Avastin) Eye Drops for Corneal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1481.
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To evaluate the short- and long-term in vivo safety of topical Bevacizumab (Avastin) application for treatment of corneal neovascularization due to a variety of corneal diseases.
Twenty-nine eyes of 26 patients with corneal neovascularisation (not responding to conventional anti-inflammatory treatment) due to different underlying corneal diseases (limbal stem cell deficiency after chemical burn, corneal graft rejection, keratoplasty, herpetic keratitis, measles keratitis, ocular pemphigoid, Steven-Johnson syndrome, recurrent pterygium) received topical Bevacizumab (Avastin) treatment (eye drops containing 5 mg/ml Bevacizumab) for 0.5 - 9 months with application from 1 - 10 times/day (usually 5 times/day). At each visit, a routine Snellen visual acuity assessment was performed followed by ophthalmic examination including fluorescein staining. Changes of corneal neovascularization were assessed using corneal photographs.
7 patients (7 eyes) showed corneal epithelial defects during topical Bevacizumab treatment, but 6 of these patients already had preexisting epithelial defects prior to treatment. The one remaining eye had a persistent epithelial defect after pannectomy and limbal stem cell transplantation. In all other patients no new epithelial defects were observed. Corneal sensitivity was difficult to assess in most patients due to multiple previous corneal operations. None of the 26 patients complained about any drug-related ocular or systemic adverse events during follow-up. No allergic reactions were observed.
Off-label topical Bevacizumab therapy for corneal neovascularization due to different corneal diseases was generally well tolerated for up to 9 months. While the long-term safety of topical Bevacizumab remains to be determined, our results suggest that off-label use of Bevacizumab eye drops is a safe and well tolerated option for the treatment of corneal neovascularization.
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