June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Response to antiangiogenic treatment with mitomycin-C in corneal neovascularization
Author Affiliations & Notes
  • Daniel Chavez Velazquez
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Karla Maria Arteaga-Rivera
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Abril Lucina García-Terrazas
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Jesus Guerrero
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Carlos Adolfo Muller Morales
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Arturo Ramírez-Miranda
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Alejandro Navas
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Enrique O Graue-Hernandez
    Cornea, External Diseases and Refractive Surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Daniel Chavez Velazquez None; Karla Arteaga-Rivera None; Abril García-Terrazas None; Jesus Guerrero None; Carlos Muller Morales None; Arturo Ramírez-Miranda None; Alejandro Navas None; Enrique Graue-Hernandez None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 914 – A0278. doi:
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      Daniel Chavez Velazquez, Karla Maria Arteaga-Rivera, Abril Lucina García-Terrazas, Jesus Guerrero, Carlos Adolfo Muller Morales, Arturo Ramírez-Miranda, Alejandro Navas, Enrique O Graue-Hernandez; Response to antiangiogenic treatment with mitomycin-C in corneal neovascularization. Invest. Ophthalmol. Vis. Sci. 2022;63(7):914 – A0278.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Maintaining transparency and avascularity is essential to preserve optimal vision. The administration of mitomycin-C (MMC) has been used intravenously for a hypoxic and embolic effect. This study aims to describe clinical outcomes of intravascular MMC for the treatment of corneal neovascularization.

Methods : A pilot study of 8 eyes with corneal neovascularization injection 0.1ml of MMC. Quantification of neovascularization was measured by an independent observer. ImageJ software (NIH, Bethesda Maryland) was used to trace and quantify vasculature in standardized clinical slitlamp photographs. Briefly all identifiable vessels were drawn upon and the number of pixels quantified. Each image was measured 3 times. Follow-up was done at 1 week, 1 month and 2 months post-injection. Preop and postop values were compared using t-test and statically significant value was set at p < 0.5.

Results : A total of 8 subjects were enrolled, of which 37.5% were female with an age range of 17-64 years (average of 37 years). In 62.5% of the cases the left eye was affected. The most frequent etiology responsible for the corneal vascularization was history of herpetic keratitis in 75% of the subject, phlyctenular keratoconjunctivis in 12.5%, and neovascularization secondary to intrastromal rings in 12.5%. One subject 12.5% presented herpes keratitis reactivation 7 days after injection, despite being on oral antiviral suppression therapy. Mean preoperative UDVA was 1.01 (+ 0.42), CDVA was 0.76 (+0.53) LogMAR. Postoperative UDVA was 0.91 (+0.42) and CDVA was 0.63 (+0.42) LogMAR with no statistically significant differences when preop and postop values were compared p>0.05. Two patients improved both UDVA and CDVA. Comparing photographs, there was an overall reduction of 60.27% of pixels in corneal vascularization at the las follow-up.

Conclusions : Corneal intrastromal MMC may be a potential therapeutic strategy to treat corneal neovascularization. Here we present short term results demonstrating that neovascularization may be reduced with clinically significant results, thus rendering this patients more suitable for optical surgical procedures. Despite regression of neovascularization visual acuity may not improve particularly if stroma is scarred. Further studies are needed to address its safety and long-term effects.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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