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R. Calvo, E. Tarrago, J. Vila, P. Bayo, O. Stirbu, L. Anselem, F. Marin; Effects of Bevacizumab, Pegaptanib and Ranibizumab on the Corneal Endothelium. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3953.
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© ARVO (1962-2015); The Authors (2016-present)
Bevacizumab, Pegaptanib and Ranibizumab are known to be safe for the human corneal endothelium in vitro, yet no in vivo effects were reported. We evaluate the morphologic and functional changes induced in the corneal endothelium by intravitreal injections of Bevacizumab, Pegaptanib and Ranibizumab.
In this prospective clinical study, 60 eyes from 60 patients were assigned to receive intravitreal injection of either Bevacizumab (1.25mg) (N:20), Pegaptanib (0.3 mg) (N:20) or Ranbizumab (0.5mg) (N:20). The exclusion criteria were: Corneal dystrophy or corneal degeneration, ocular trauma history, pregnancy and a corneal endothelial density lower than 500 cells/mm2. Corneal endothelial analysis was performed one month pre- and postoperatively. Specular microscopy was used to capture the corneal endothelial images(SF-2000P,TopconTM), which were analyzed with Imagenet-2000 (TopconTM) software. The following variables were measured: Endothelial cell density (ECD), pleomorphism, expressed as the proportion of hexagonal cells (%Hex), and polymegathism, expressed as the coefficient of variation (CoV).
The anti VEGF intravitreal injections were administered in 60 patients (mean age 64±10.9 years). The preoperative average data were ECD: 1869, CoV: 28 and %Hex: 62. Postoperatively the average ECD was 1853, CoV: 28 and %Hex: 63. The results obtained in the three different treatment subgroups are shown in the attached table. No statistically significant differences were observed in the Bevacizumab, Pegaptanib and Ranibizumab subgroups.A subgroup analysis considering if the patients were phakic (38%) or pseudophakic (62%) was performed and no statistically differences were observed.
This short term study suggests that Bevacizumab, Pegaptanib and Ranibizumab, at concentrations normally used in clinical practice, are not toxic to the human corneal endothelium, yet longer term studies are needed.
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