Treatment of Pyogenic Granulomas with Intralesional Injections of Bevacizumab

Abstract

Purpose : To report the safety and efficacy of adjuvant bevacizumab in the treatment of ocular pyogenic granuloma manifestation after pterygiectomy.

Methods : We present 2 eyes with formations of pyogenic granulomas after undergoing combined pterygiectomies and amniotic membrane graftings. Intralesional triamcinolone injections did not show sign of regression. Additional injections of bevacizumab were performed.

Results : Within a month of intralesional injections with bevacizumab, the vascular lesions showed complete resolution with no adverse effect.

Conclusions : Intralesional bevacizumab injection is a safe and effective adjuvant therapy in the treatment of post-pterygiectomy conjunctival pyogenic granuloma refractory to steroid therapy.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Figure 1. (A) Color photo showing a 4.2 mm pterygium located nasally in the right eye prior to combined pterygiectomy and amniotic membrane graft surgery. (B) Color photo illustrating vascular lesion growth 2 month post-pterygiectomy. The patient received a 0.03ml triamcinolone injection (40mg/ml). (C) Slit lamp examination of vascular lesion, 1 week post-triamcinolone injection. The vascular lesion appears to be less red. No signs of the growth regressing. The patient received bevacizumab injection (1.25mg/0.05ml). (D) 1 day post bevacizumab injection. The lesion size significantly reduced. (E) Slip lamp examination of lesion, 1 week post-bevacizumab injection. Tissue growth is less erythematous. (F) Slit lamp examination of lesion, 3 week post-bevacizumab injection. Pyogenic granuloma lesion resolved with no hyperemia.

 

Figure 2. Examination of appearance of the pyogenic granuloma with one intralesional bevacizumab injection in the right eye, post-op 1 day (left) and 2 week (right).