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Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens–Johnson syndrome

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Abstract

Purpose

To investigate the effectiveness of combined photodynamic therapy with verteporfin and intrastromal injection of bevacizumab for the treatment of corneal neovascularization in patients with Stevens–Johnson syndrome (SJS).

Methods

Eight eyes of eight patients with SJS having corneal neovascularization who were refractory to 1% prednisolone instillation received photodynamic therapy with verteporfin (6 mg/m2) combined with intrastromal bevacizumab injection (2.5 mg/0.1 mL). Best-corrected visual acuity and intraocular pressure were assessed, and slit-lamp biomicroscopic examination was performed before treatment and at 1 week and every month. A chronic ocular manifestation score was assigned based on the involvement area or the severity before treatment. The cumulative length of corneal blood vessels and area of corneal neovascularization were measured by anterior segment photographs before and after treatment.

Results

At 3 and 6 months after treatment, all eyes showed regression of corneal neovascularization. Complete regression was achieved in five eyes (62.5%) and partial regression in three eyes (37.5%). Among five patients who were followed up for more than 1 year, two eyes maintained complete regression and one eye maintained partial regression at 1 year. However, two eyes with severe chronic ocular manifestation showed revascularization.

Conclusions

Combined photodynamic therapy with intrastromal bevacizumab injection can effectively inhibit corneal neovascularization in patients with SJS. However, patients with severe chronic ocular manifestation may exhibit revascularization.

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Acknowledgements

This study was partially supported by the Chonnam National University Hospital Biomedical Research Institute (CRI 13906-22) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1A2B4003367).

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Authors and Affiliations

  1. Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 501-757, South Korea

    Hyeon Jeong Yoon & Kyung Chul Yoon

  2. Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, South Korea

    Mee Kum Kim

  3. Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea

    Kyung Yul Seo

  4. Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Hirokoji, Kawaramachi, Kamigyoku, Kyoto, 602-0841, Japan

    Mayumi Ueta

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  1. Hyeon Jeong Yoon
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  2. Mee Kum Kim
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  3. Kyung Yul Seo
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  5. Kyung Chul Yoon
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Correspondence to Kyung Chul Yoon.

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All authors declare that he/she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Yoon, H.J., Kim, M.K., Seo, K.Y. et al. Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens–Johnson syndrome. Int Ophthalmol 39, 55–62 (2019). https://doi.org/10.1007/s10792-017-0786-x

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  • DOI: https://doi.org/10.1007/s10792-017-0786-x

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