Regression of Aggressive Corneal Vascularization After Photodynamic Therapy, Subconjunctival Avastin Injections and Topical Cyclosporin-A 1% Drops: A Case Report

Overview

Journal Saudi J Ophthalmol

Specialty Ophthalmology

Date 2013 Aug 21

PMID 23960893

Citations 2

Authors

Omar M Kirat

Hassan A Al-Dhibi

Affiliations

Soon will be listed here.

Abstract

We describe a case of significant regression of aggressive, deep and superficial corneal vascularization using photodynamic therapy (PDT) with verteporfin, repeated subconjunctival injections of Avastin®, plus topical cyclosporin-A 1% drops. The area of the corneal vascularization was treated with PDT with verteporfin. The subconjunctival space - next to the area of vascularization - was injected with Avastin® (1.25 mg/0.05 ml), immediately after PDT, and then for two more times during the follow-up period. The patient was kept on topical cyclosporin and prednisolone acetate. The outcome was evaluated clinically and photographically for 13 months. Corneal vascularization regressed significantly. No adverse effects were observed, neither locally or systemically. PDT with verteporfin, repeated subconjunctival injections of Avastin®, and topical cyclosporin-A drops appear to be safe and effective in treating aggressive corneal vascularization.

Citing Articles

Comparison of the Therapeutic Efficacies of Topical Rivoceranib and Topical Bevacizumab in a Murine Model of Corneal Neovascularization.

Yoon H, Woo J, Ji Y, Yoon K Medicina (Kaunas). 2019; 55(11).

PMID: 31703332 PMC: 6915418. DOI: 10.3390/medicina55110729.

Current and emerging therapies for corneal neovascularization.

Roshandel D, Eslani M, Baradaran-Rafii A, Cheung A, Kurji K, Jabbehdari S Ocul Surf. 2018; 16(4):398-414.

PMID: 29908870 PMC: 6461401. DOI: 10.1016/j.jtos.2018.06.004.

References

McNatt L, Weimer L, Yanni J, Clark A . Angiostatic activity of steroids in the chick embryo CAM and rabbit cornea models of neovascularization. J Ocul Pharmacol Ther. 1999; 15(5):413-23. DOI: 10.1089/jop.1999.15.413. View

Koenig Y, Bock F, Horn F, Kruse F, Straub K, Cursiefen C . Short- and long-term safety profile and efficacy of topical bevacizumab (Avastin) eye drops against corneal neovascularization. Graefes Arch Clin Exp Ophthalmol. 2009; 247(10):1375-82. DOI: 10.1007/s00417-009-1099-1. View

Mendelsohn A, Stock E, Lo G, Schneck G . Laser photocoagulation of feeder vessels in lipid keratopathy. Ophthalmic Surg. 1986; 17(8):502-8. View

Hernandez G, Volpert O, Iniguez M, Lorenzo E, Martinez-Martinez S, Grau R . Selective inhibition of vascular endothelial growth factor-mediated angiogenesis by cyclosporin A: roles of the nuclear factor of activated T cells and cyclooxygenase 2. J Exp Med. 2001; 193(5):607-20. PMC: 2193389. DOI: 10.1084/jem.193.5.607. View

Mailath L, Peter M . [Beta-ray therapy of corneal vascularization after keratoplasty]. Klin Monbl Augenheilkd. 1972; 160(5):554-9. View

Teng C, Patel N, Jacobson L . Effect of subconjunctival bevacizumab on primary pterygium. Cornea. 2009; 28(4):468-70. DOI: 10.1097/ICO.0b013e31818d382d. View

Dua H, Azuara-Blanco A . Corneal allograft rejection: risk factors, diagnosis, prevention, and treatment. Indian J Ophthalmol. 2005; 47(1):3-9. View

Yoon K, You I, Kang I, Im S, Ahn J, Park Y . Photodynamic therapy with verteporfin for corneal neovascularization. Am J Ophthalmol. 2007; 144(3):390-395. DOI: 10.1016/j.ajo.2007.05.028. View

Benelli U, Ross J, Nardi M, Klintworth G . Corneal neovascularization induced by xenografts or chemical cautery. Inhibition by cyclosporin A. Invest Ophthalmol Vis Sci. 1997; 38(2):274-82. View

10.

Lim M, Jacobs D, Rosenthal P, Carrasquillo K . The Boston Ocular Surface Prosthesis as a novel drug delivery system for bevacizumab. Semin Ophthalmol. 2009; 24(3):149-55. DOI: 10.1080/08820530902802013. View

11.

Fallah M, Khosravi K, Hashemian M, Beheshtnezhad A, Rajabi M, Gohari M . Efficacy of topical bevacizumab for inhibiting growth of impending recurrent pterygium. Curr Eye Res. 2009; 35(1):17-22. DOI: 10.3109/02713680903395273. View

12.

Fossarello M, Peiretti E, Zucca I, Serra A . Photodynamic therapy of corneal neovascularization with verteporfin. Cornea. 2003; 22(5):485-8. DOI: 10.1097/00003226-200307000-00018. View

13.

Regenfuss B, Bock F, Bachmann B, Konig Y, Hos D, Parthasarathy A . [Topical inhibition of angiogenesis at the cornea. Safety and efficacy]. Ophthalmologe. 2009; 106(5):399-406. DOI: 10.1007/s00347-009-1934-0. View

14.

Vassileva P, Hergeldzhieva T . Avastin use in high risk corneal transplantation. Graefes Arch Clin Exp Ophthalmol. 2009; 247(12):1701-6. DOI: 10.1007/s00417-009-1170-y. View

15.

Boneham G, Collin H . Steroid inhibition of limbal blood and lymphatic vascular cell growth. Curr Eye Res. 1995; 14(1):1-10. DOI: 10.3109/02713689508999908. View

16.

Pillai C, Dua H, Hossain P . Fine needle diathermy occlusion of corneal vessels. Invest Ophthalmol Vis Sci. 2000; 41(8):2148-53. View