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Intrastromal bevacizumab in the management of corneal neovascularization: a retrospective review

  • Cornea
  • Published:
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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.

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Author notes

  1. Archana A. Gupta and Danny A. Mammo contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Phillips Wagensteen Building, Ninth Floor, 516 Delaware Street SE, Minneapolis, MN, 55455, USA

    Archana A. Gupta, Danny A. Mammo & Michael A. Page

Authors
  1. Archana A. Gupta
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  2. Danny A. Mammo
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  3. Michael A. Page
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Correspondence to Danny A. Mammo.

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Gupta, A.A., Mammo, D.A. & Page, M.A. Intrastromal bevacizumab in the management of corneal neovascularization: a retrospective review. Graefes Arch Clin Exp Ophthalmol 258, 167–173 (2020). https://doi.org/10.1007/s00417-019-04519-4

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  • DOI: https://doi.org/10.1007/s00417-019-04519-4

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