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K. M. AlArfaj, M. H. Dastjerdi, P. Hamrah, R. Dana; Significant Narrowing of Corneal Blood Vessel Diameter - A Prominent Neovascular Alteration in Response to Topical Bevacizumab Therapy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3742.
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To report the clinical response to topical bevacizumab (Avastin) therapy in 5 eyes of 5 patients with corneal neovascularization in an ongoing prospective open-label, non-controlled clinical study.
Patients with stable corneal neovascularization, either superficial or deep, that extended ≥ 2 mm from the limbus were treated with a formulation of 1.0% (10mg/ml) concentration of bevacizumab, twice a day for 3 weeks. The patients were examined at 1, 3, 6, 12, and 24 weeks after initiation of treatment. Slit lamp examination, tonometry, central corneal pachymetry, systemic blood pressure measurement, and slit-lamp photography were completed at all visits. For safety measures, all adverse events (ocular and systemic) were monitored and recorded throughout the course of the study. For efficacy measures, corneal photographs at baseline were compared with the follow-up photographs.
Systemic blood pressure remained stable at the baseline level during the treatment and all the follow-up visits in all 5 patients. No systemic or ocular adverse events, including thromboembolic events, hemorrhage, hypertension, allergic reaction, ocular surface toxicity and epitheliopathy, or burning on instillation, were reported. Three weeks after initiation of topical anti-VEGF therapy, superficial and deep stromal corneal new vessels in all 5 patients showed remarkable narrowing in the diameter. However, no changes in the length of the vascular sprouts in these stably formed cases of neovascularization were observed. These therapeutic effects reached the maximum level by six weeks.
The significant narrowing of corneal blood vessel diameter in response to topical bevacizumab therapy provides evidence that anti-VEGF could potentially offer an alternative or adjunctive measure to conventional therapies in modulating leakage and/or cellular extravasation in corneal neovascularization.
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