Background: Corneal neovascularization (NV) can occur as a consequence of anterior segment inflammation, injury and ischemia. This pathological response can cause visual impairment or other conditions such as corneal edema, corneal scarring, lipid deposition, increased risk of graft rejection after corneal transplantation, and bleeding during corneal flap preparation in laser in situ keratomileusis (LASIK) surgery. Many studies have shown that anti- vascular endothelial growth factor agents can inhibit corneal neovascularization. One such inhibitor is bevacizumab, a humanized murine monoclonal antibody against all vascular endothelial growth factor isoforms.
Objective: To evaluate the results of using topical bevacizumab (Avastin) as a treatment of corneal neovascularization due to different causes.
Patients and methods: In this study, Bevacizumab was used topically as eye drops with a concentration of 0.5 mg/ml. Total 30 eyes were included in this study. All were diagnosed with corneal neovascularization. Careful history was taken from all patients and they underwent ophthalmological examination including slit lamp biomicroscopy examination , color photos of the anterior segment and intra oculae pressure . All cases were selected from outpatient clinic of the Ophthalmology Department at Al-AzharUniversityHospital (Cairo) from October 2018 to October 2020.
Results: The corneal opacity decreased in 13.3% of the studied group. However, the remaining 86.7% didn't show any change at all. The best corrected visual acuity (BCVA) improved in about one third of the studied group (33.3%). However, the remaining 66.7% didn't show any change at all. There was ahighly significant difference between the studied group as regarding effect of Avastin on neovascularization after one and two weeks. It was noticed that moderate response increased from the first to the second week (3.3% versus 56.7% respectively). There were highly statistically significant differences between the different pathologies as regarding Avastin's effect on corneal neovascularization after both one and two weeks.
Conclusion: The use of topical bevacizumab (avastin) eye drops in cases of corneal NV was safe, well tolerated, associated with mild to moderate regression of corneal NV and not associated by any drug related side effects.