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Tais Hitomi Wakamatsu, Alessandra Yoshie Takiishi, Flávio Hirai, Acácio Souza Lima, Jose Alvaro Pereira Gomes; The Efficacy of Topical Bevacizumab and Sunitinib on Corneal Neovascularization in patients with Stevens-Johnson.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3329.
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We performed a prospective, randomized, double blind, placebo controlled study to evaluate the effect of topical bevacizumab and sunitinib in the treatment of corneal neovascularization in patients with Stevens-Johnson syndrome (SJS).
36 eyes of 26 patients (9 males and 17 females) with SJS and corneal neovascularization (≥ 2mm from the limbus) were examined in this study. Patients were randomized to 1 of 3 groups: Group 1 received carboxymethyl cellulose 0.5%, Group 2 bevacizumab 10mg/ml, and Group 3 sunitinib 5mg/ml. All treatments were administered 4 times daily for one month. All subjects underwent best correct visual acuity (BCVA), Schirmer test, tear film break up time, fluorescein/ lisamine green stainings, pachymeter, confocal scanning microscopy and photographs were taken on a slit lamp before the treatment and on months 1, 2, 3, 4, 5 and 6. The area of neovascularization was measured in pixels2.
BCVA showed significant improvement in patients treated with bevacizumab on the second month after treatment (p=0.013) and with sunitinib on the fourth and sixth month after treatment (p=0.030 and p=0.029 respectively). There were no significant differences in the quantitative data of fluorescein and lisamine green stainings for those who were treated with bevacizumab and sunitinib eye drops. From the baseline visit to the last follow-up visit, mean reductions were 31.11% for bevacizumab and 33.20% for sunitinib. On month 3,4 and 6 the mean percentages of areas of corneal neovascularization in the sunitinib treated eyes were smaller compared with carboxymethyl cellulose treated group (p=0.02, p=0.01, p=0.02).
Topical administration of both bevacizumab and sunitinib inhibits corneal neovascularization in SJS patients. Furthermore, blocking both VEGF and platelet-derived growth factor pathways applying topical administration of sunitinib yields better results than bevacizumab.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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