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Subconjunctival Bevacizumab Injection for Corneal Neovascularization

Bahar, Irit MD; Kaiserman, Igor MD, MSc, MHA; McAllum, Penny MBChB, FRANZCO; Rootman, David MD, FRCSC; Slomovic, Allan MA, MD, FRCSC

doi: 10.1097/ICO.0b013e318159019f
Clinical Science

Purpose: To report on the clinical use of subconjunctival bevacizumab in patients with corneal neovascularization.

Methods: The charts of 10 consecutive patients with corneal neovascularization who received subconjunctival injections of bevacizumab (2.5 mg/0.1 mL) were reviewed. Digital photographs of the cornea were graded by 2 masked observers for density, extent, and centricity of corneal vascularization. Image analysis was used to determine the area of cornea covered by neovascularization as a percentage of the total corneal area.

Results: No significant ocular or systemic adverse events were observed during 3.5 ± 1.1 months of follow-up. Seven patients showed partial regression of vessels. The extent decreased from 6.0 ± 1.2 (SD) clock hours before the injection to 4.6 ± 1.0 clock hours after bevacizumab injection (P = 0.008). Density decreased from 2.7 ± 0.2 to 1.9 ± 0.3, respectively. (P = 0.007). No change was noticed in the centricity of corneal vessels. Corneal neovascularization covered, on average, 14.8% ± 2.5% (SD) of the corneal surface before the injections, compared with 10.5% ± 2.8% (P = 0.36, t test) after bevacizumab injection. Therefore, bevacizumab decreased corneal neovascularization by 29%.

Conclusions: Short-term results suggest that subconjunctival bevacizumab is well tolerated and associated with a partial regression of corneal neovascularization.

From the Department of Ophthalmology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

Received for publication June 23, 2007; revision received August 15, 2007; accepted August 16, 2007.

Reprints: Irit Bahar, MD, Department of Ophthalmology, Toronto Western Hospital, 399 Bathurst Street, Ontario, Canada M5T2S8 (e-mail: iritbahar@yahoo.com).

© 2008 Lippincott Williams & Wilkins, Inc.