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Recurrence of Corneal Neovascularization Associated With Lipid Deposition After Subconjunctival Injection of Bevacizumab

Chu, Hsiao-Sang MD*; Chen, Ta-Ching MD*; Hu, Fung-Rong MD*,†; Chen, Wei-Li MD, PhD*,†

doi: 10.1097/ICO.0b013e31825ec407
Clinical Science

Purpose: To report 7 cases of recurrent corneal neovascularization (NV) and lipid deposition after subconjunctival injection of bevacizumab for the treatment of corneal NV–induced lipid keratopathy.

Methods: We conducted a prospective interventional case series that included 20 eyes of chronic lipid keratopathy that received bevacizumab injection for the treatment of corneal NV and lipid deposition, including 7 eyes with recurrent corneal NV and lipid deposition after ceasing treatment. Repeated subconjunctival injections of bevacizumab were performed in 5 patients with recurrence. Penetrating keratoplasty was performed in 1 patient who had severely recurrent lipid deposition. Clinical presentation of corneal NV and lipid deposition, best-corrected visual acuity, and complications after treatments were recorded.

Results: Bevacizumab inhibited corneal NV and lipid depositions in 19 patients. Seven of the 20 patients (35%) had different patterns of recurrence of corneal NV/lipid deposition 6 to 15 months after discontinuing treatment. Five of the 7 patients in whom corneal NV/lipid deposition was recurrent received another course of repeated bevacizumab treatments. Three eyes had partial response to the second course of treatment. Two eyes had too short re-treatment course to have conclusions. One patient who received penetrating keratoplasty had successful result after surgery.

Conclusions: Corneal NV and lipid deposition may recur after ceasing the subconjunctival bevacizumab injections for lipid keratopathy. Some patients respond at least partially to repeated injections.

*Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

Center for Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan.

Reprints: Wei-Li Chen, Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei, Taiwan (e-mail: chenweili@ntu.edu.tw).

Supported, in part, by the Department of Medical Research at the NTUH, the Research Grant NTUH 97-S831, 98A103, 100S-1633, National Taiwan University Hospital, Taipei, Taiwan and Grant NSC 97-2314-B-002-085-MY3 from the National Science Council, the Executive Yuan, Taiwan.

The authors have no proprietary interest in the research presented here.

The first and second authors contributed equally to this article.

Received July 11, 2011

Accepted May 09, 2012

© 2013 by Lippincott Williams & Wilkins.