Abstract
Purpose::
To determine efficacy of bevacizumab (Avastin®), an anti-VEGF (vascular endothelial growth factor) monoclonal antibody, administrated via subconjunctival (sc) as a corneal anti-angiogenic treatment and to evaluate the role of neovascular inhibition on the inflammatory response due to herpetic stromal keratitis (HSK).
Methods::
Both corneas of rabbits were infected with KOS strain herpes simplex virus (HSV-1). Clinical and histological lesions were graded and scored while they progressed in severity. On day 13 after infection animals have been treated with a sc single dose of bevacizumab 10 µl (25 µg/ul) in the right eye, or 10 µl of saline solution in the left control eyes. Corneas were obtained for histological assessment and viral titration by days 2, 5, 7, 14 and 28 after infection
Results::
Treated eyes with sc bevacizumab showed a significant decrease in the severity of HSK, reverted corneal opacity, showed no scars, nor corneal thinning. Involution of neovascularization was total. All these changes were not observed in untreated eyes. Viral replication was observed no longer than 5 days after infection. By day 7 was detected dense neutrophil invasion of the cornea, which significantly decreased after bevacizumab injection.
Conclusions::
Bevacizumab via sc was effective to produce neovascular inhibition and could be a novel approach to achieve regression of corneal new vessels in HSK. Anti-VEGF induced involution of new vessels abolished inflammatory response in HSK and resulted in fully functional corneas. Bevacizumab sc treatment did not induce viral replication.
Keywords: cornea: clinical science • inflammation • herpes simplex virus