INTEREST OF SUBCONJUNCTIVAL INJECTIONS OF BEVACIZUMAB IN THE TREATMENT OF CORNEAL NEOVESSELS: ABOUT 20 CASES

Published 2023 - 27th ESCRS Winter Meeting

Reference: P150 | Type: Presented Poster & Poster Submission | DOI: 10.82333/xf4q-my11

Authors: Arab Lamiaa* ¹ , manal samie ¹ , samia zamzami ¹

¹ophtalmology,University hospital 20 Août 1953 casablanca,Casablanca,Morocco

Purpose

The aim of our study is to evaluate the efficacy and safety of bevacizumab injected subconjunctivally in the treatment of corneal neovessels, all etiologies included.

Setting

The cornea is a transparent tissue because it is normallyavascular. Neovascularization can occur as a result of variouspathologies reducing corneal transparency and thus visual acuity. Treatment of corneal neovessels is verydifficult. The identification of the essential role of vascular endothelialgrowth factor (VEGF-A) in angiogenesis has led to the use of bevacizumab (Avastin®), which is a humanized monoclonal antibody antibody directed against all forms of VEGF-A, in the treatment of this severe pathology

Methods

We performed a retrospective descriptive study. All patients with corneal neovascularization were included, regardless of pathology. Each patient received at least three subconjunctivalinjections of 0.2ml (20 units from an insulin syringe) of Bevacizumab. The primary endpoint was the reduction of more than 30% of the neovascularized corneal surface after the first two injections. The second endpoint was visual acuity. an interval of 1 month was observed between each injection. the patients were examined monthly with a slit lamp and iconographic follow-up was performed.

Results

We included in our study 20 eyes with cornealneovasuclarization. The mean age of the patients was 42.1 years (range 7-70 years). The number of subconjunctivalinjections ranged from 4 to 10 with an average of 8 injections. No local or general side effect was recorded. Of the 20 eyesincluded, efficacity was evident in only 6 cases, wich confirmsthe existence of good factors response to bevacizumab: recentneovasuclarisation (less than 6 months), superficialneovascularisation, a small neovascularized corneal surface (less than 1/4 of corneal surface).

Conclusion

Our study seems to highlight the efficacy of bevacizumab by subconjunctival injection at a dose of 0.2 ml per month in

the treatment of corneal neovascularization after the 3rd injection.

The regression of the neovessels was partial in all cases, whichallows us to say that bevacizumab can be an excellent means of stopping the progression of the neovessels.

Visual acuity remained unchanged despite repeatedbevacizumab injections. Indeed, in these patients, the declinein visual acuity is not only due to corneal neovascularization but also to its consequences on the cornea (opacity, astigmatism, etc.). However, the regression of neovascularization can improve the prognosis of other therapeutic means, in particularcorneal transplantation.