[Antiangiogenic therapy for pterygium recurrence].
OBJECTIVE
A pterygium is defined as a fibrovascular and hyperplastic proliferative degeneration tissue of the limbus. Although the pathogenesis is not yet clearly understood there are indications that vascular endothelial growth factor (VEGF) may play a significant role in the development. Despite various surgical approaches recurrence remains the major postoperative problem. Bevacizumab is a human monoclonal antibody against VEGF. Its antiangiogenic effect is used in ophthalmology as an off-label treatment for retinal disease. We report about the use of Bevacizumab eye drops to prevent repeated recurrence of pterygia.


METHODS
In our clinic 5 eyes (4 patients) were treated with topical Bevacizumab eye drops (25 mg/ml) 2-8 times per day for 5-24 weeks as an adjunct after excision of recurrent pterygia and conjunctival autograft. Patients were examined preoperatively and over a follow-up period ranging from 3-14 months (median 12 months).


RESULTS
Visual acuity improved in 3 out of 5 eyes and in 1 eye no pterygium recurrence was noted. Two eyes showed conjunctival hyperemia (stage 1 recurrence) and one eye showed fibrosis of the limbus (stage 2 recurrence). In one eye an early recurrence with corneal vascularisation and superficial punctate keratopathy was observed (stage 3 recurrence). No serious permanent complications were observed.


CONCLUSIONS
Considering the previously multiple recurrences in our patients we think that these first clinical mid-term follow-up experiences support the use of topical VEGF inhibitors in recurrent pterygia.
Leippi
S
S
Klinik für Augenheilkunde, Universitätsaugenklinik, Josef-Schneider-Strasse 11, 97080, Würzburg.
Grehn
F
F
Geerling
G
G
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011625:Pterygium / Q000188:drug therapy* / Q000517:prevention & control*; D055502:Secondary Prevention; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab