Archana A Gupta1, Danny A Mammo2, Michael A Page1. 1. Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Phillips Wagensteen Building, Ninth Floor, 516 Delaware Street SE, Minneapolis, MN, 55455, USA. 2. Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Phillips Wagensteen Building, Ninth Floor, 516 Delaware Street SE, Minneapolis, MN, 55455, USA. mammo004@umn.edu.
Abstract
PURPOSE: To evaluate the long-term safety and efficacy of intrastromal bevacizumab for treatment of deep corneal neovascularization in candidates for high-risk cornea grafting. METHODS: A single-center retrospective study involving 14 eyes of 14 patients with chronic deep corneal neovascularization, treated with intrastromal bevacizumab by a single provider from 2011 to present. Intrastromal bevacizumab (0.05-0.1 mL of 2.5 mg/0.1 mL) was administered every 4-8 weeks. On average 1-3 intrastromal injections were performed prior to corneal grafting (penetrating keratoplasty or deep anterior lamellar keratoplasty). RESULTS: 64.2% patients had neurotrophic keratitis secondary to herpes zoster or simplex. Neovascularization was encroaching the visual axis in 50% and was paracentral in 42.8%. After intrastromal bevacizumab injection, 14.2% had complete regression of neovascularization, avoiding the need of future corneal transplant. Persistent neovascularization was noticed in 21.4%. Successful penetrating keratoplasty was performed in 57% of patients. Minimal adverse effects were noted; temporary epithelial defect was seen in two eyes and self-limited intrastromal hemorrhage in one. There was no evidence of recurrence of neovascularization or graft rejection in the transplant group (mean follow-up 3 years). CONCLUSION: Intrastromal bevacizumab appears to be a safe and effective modality in the treatment of chronic corneal neovascularization, producing durable regression of corneal neovascularization and allowing for durable success of subsequent corneal transplants in high-risk patients.
PURPOSE: To evaluate the long-term safety and efficacy of intrastromal bevacizumab for treatment of deep corneal neovascularization in candidates for high-risk cornea grafting. METHODS: A single-center retrospective study involving 14 eyes of 14 patients with chronic deep corneal neovascularization, treated with intrastromal bevacizumab by a single provider from 2011 to present. Intrastromal bevacizumab (0.05-0.1 mL of 2.5 mg/0.1 mL) was administered every 4-8 weeks. On average 1-3 intrastromal injections were performed prior to corneal grafting (penetrating keratoplasty or deep anterior lamellar keratoplasty). RESULTS: 64.2% patients had neurotrophic keratitis secondary to herpes zoster or simplex. Neovascularization was encroaching the visual axis in 50% and was paracentral in 42.8%. After intrastromal bevacizumab injection, 14.2% had complete regression of neovascularization, avoiding the need of future corneal transplant. Persistent neovascularization was noticed in 21.4%. Successful penetrating keratoplasty was performed in 57% of patients. Minimal adverse effects were noted; temporary epithelial defect was seen in two eyes and self-limited intrastromal hemorrhage in one. There was no evidence of recurrence of neovascularization or graft rejection in the transplant group (mean follow-up 3 years). CONCLUSION: Intrastromal bevacizumab appears to be a safe and effective modality in the treatment of chronic corneal neovascularization, producing durable regression of corneal neovascularization and allowing for durable success of subsequent corneal transplants in high-risk patients.
Authors: Ana Carolina Cabreira Vieira; Ana Luisa Höfling-Lima; José Álvaro P Gomes; Denise de Freitas; Michel Eid Farah; Rubens Belfort Journal: Arq Bras Oftalmol Date: 2012 Jul-Aug Impact factor: 0.872
Authors: Sheng-Fu Cheng; Mohammad H Dastjerdi; Giulio Ferrari; Andre Okanobo; Kraig S Bower; Denise S Ryan; Francisco Amparo; William Stevenson; Pedram Hamrah; Nambi Nallasamy; Reza Dana Journal: Am J Ophthalmol Date: 2012-09-08 Impact factor: 5.258
Authors: Mohammad H Dastjerdi; Khalid M Al-Arfaj; Nambi Nallasamy; Pedram Hamrah; Ula V Jurkunas; Roberto Pineda; Deborah Pavan-Langston; Reza Dana Journal: Arch Ophthalmol Date: 2009-04